AJR:185, December 2005 1575 AJR 2005; 185:1575–1581 0361–803X/05/1856–1575 © American Roentgen Ray Society Sailer et al. CT Enteroclysis in Patients with Crohn’s Disease Gastrointestinal Imaging • Original Research Diagnostic Value of CT Enteroclysis Compared with Conventional Enteroclysis in Patients with Crohn’s Disease Johannes Sailer 1 Philipp Peloschek 1 Ewald Schober 1 Wolfgang Schima 1 Walter Reinisch 2 Harald Vogelsang 2 Patrick Wunderbaldinger 1 Karl Turetschek 1 Sailer J, Peloschek P, Schober E, et al. DOI:10.2214/AJR.04.1534 Received September 29, 2004; accepted after revision December 10, 2004. 1 Department of Radiology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria. Address correspondence to J. Sailer (johannes.sailer@meduniwien.ac.at). 2 Department of Internal Medicine 4, Division of Gastroenterology, Medical University of Vienna, Vienna, Austria. OBJECTIVE. The objective of our study was to assess the diagnostic value of CT enteroclysis compared with conventional enteroclysis in patients with Crohn’s disease. SUBJECTS AND METHODS. Fifty consecutive patients (26 women, 24 men; mean age, 36.3 years; age range, 18–52 years) with histologically proven Crohn’s disease underwent CT enteroclysis and conventional enteroclysis (median time interval, 21.7 days) during a symp- tomatic stage of their disease. Both techniques were compared with regard to diagnostic yield in assessing the presence and extent of disease. Imaging findings were compared with surgery, follow-up examinations, or both. RESULTS. CT enteroclysis and conventional enteroclysis were successfully performed in all 50 patients. Crohn’s disease–associated radiographic changes were found in 44 patients (88%) using CT enteroclysis and in 42 patients (84%) using conventional enteroclysis. Signif- icantly more Crohn’s disease–associated abnormalities were diagnosed with CT enteroclysis than with enteroclysis (p < 0.01). Minimal inflammatory changes of the mucosa were diag- nosed in 44 patients (88%) using CT enteroclysis and in 42 patients (84%) using enteroclysis. Both imaging methods depicted stenotic bowel segments in 34 patients (68%), and prestenotic dilatation was diagnosed in 20 patients (40%) with CT enteroclysis and in 15 (30%) with en- teroclysis. Fistulas were found in 18 patients (36%) with CT enteroclysis and in eight (16%) with enteroclysis (p < 0.01). Skip lesions could be seen in 17 (34%) and three patients (6%), respectively (p < 0.01). Conglomeration of bowel loops tumors was diagnosed with CT enteroclysis in 13 patients (26%) and in three patients (6%) using conventional enteroclysis (p < 0.01). Only CT enteroclysis depicted abscesses in eight patients (16%) (p < 0.01). CONCLUSION. CT enteroclysis proved to be significantly superior to conventional en- teroclysis in depicting Crohn’s disease–associated intra- and extramural abnormalities. CT en- teroclysis is the imaging method of choice and should replace enteroclysis in patients with Crohn’s disease. rohn’s disease is a granulomatous inflammatory disease character- ized by transmural and segmental involvement of the intestinal wall [1]. Complications of Crohn’s disease, such as extension to the adjacent mesentery and or- gans, fistulas, abscesses, and stenoses, are found in approximately 40% of these patients [2, 3]. Patients with inflammatory and some- times even obstructive small-bowel disease require prompt and accurate treatment to re- lieve their symptoms and to minimize the risk of potential complications [4]. Conventional small-bowel enteroclysis is currently regarded as the radiologic technique of choice in evaluating small-bowel disease. Radiographic findings of mucosal abnormal- ities of the terminal ileum and the distribution pattern throughout the small bowel are indic- ative of Crohn’s disease [5–8]. Much interest has been focused on the use of cross-sectional imaging in patients with small-bowel disease because enteroclysis fails to show important extraintestinal man- ifestations of small-bowel disease [9–11]. Recently, CT enteroclysis was introduced as an alternative imaging method to overcome the individual deficiencies of CT (no disten- tion of the small bowel) and conventional enteroclysis (no extraluminal information) and to combine the advantages of both in one technique. This method has been described as highly accurate in depicting mucosal abnormalities and extraintestinal complications in patients with Crohn’s dis- ease [12–16]. C Downloaded from www.ajronline.org by 52.73.204.196 on 05/16/22 from IP address 52.73.204.196. Copyright ARRS. For personal use only; all rights reserved