Multidetector CT enterography of focal small bowel lesions: a radiological–pathological correlation

Aim. To compare the diagnostic value of multidetector CT enterography (MDCTE) and double-balloon enteroscopy (DBE) for patients with suspected small bowel diseases.Methods. From January 2009 to January 2014, 190 patients with suspected small bowel diseases were examined with MDCTE and DBE. The characteristics of the patients, detection rates, diagnostic yields, sensitivity, specificity, positive predictive value, and negative predictive value were described and analyzed.Results. The overall detection rates of DBE and MDCTE were 92.6% and 55.8%, respectively (P<0.05), while the overall diagnostic yields were 83.2% and 33.7%, respectively (P<0.05). The sensitivity, specificity, positive predictive value, and negative predictive value of DBE were all higher than those of MDCTE. DBE had a higher diagnostic yield for OGIB (87.3% versus 20.9%,P<0.05). The diagnostic yields of DBE were higher than those of MDCTE for inflammatory diseases, angioma/angiodysplasia, and diverticulums, while being not for gastrointestinal tumors/polyps.Conclusions. The diagnostic value of DBE for small bowel diseases is better than that of MDCTE as a whole, but if gastrointestinal tumors are suspected, MDCTE is also needed to gain a comprehensive and accurate diagnosis.

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Small bowel adenocarcinoma in Crohn disease: CT-enterography features with pathological correlation

Abdominal Imaging ◽

10.1007/s00261-011-9772-3 ◽

2011 ◽

Vol 37 (3) ◽

pp. 338-349 ◽

Cited By ~ 17

Author(s):

Philippe Soyer ◽

Lora Hristova ◽

Frank Boudghène ◽

Christine Hoeffel ◽

Xavier Dray ◽

...

Keyword(s):

Small Bowel ◽

Crohn Disease ◽

Small Bowel Adenocarcinoma ◽

Ct Enterography ◽

Pathological Correlation

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INFLAMMATION VS. FIBROSIS: EVALUATION OF SMALL BOWEL NARROWING IN CROHNʼS DISEASE WITH CT ENTEROGRAPHY

The American Journal of Gastroenterology ◽

10.1111/j.1572-0241.2003.08466.x ◽

2003 ◽

Vol 98 ◽

pp. S241

Author(s):

Peter D.R. Higgins ◽

Joel Platt ◽

Paul Sonda ◽

Ellen M. Zimmermann

Keyword(s):

Small Bowel ◽

Ct Enterography

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Increased Unenhanced Bowel-Wall Attenuation at Multidetector CT Is Highly Specific of Ischemia Complicating Small-Bowel Obstruction

Radiology ◽

10.1148/radiol.13122654 ◽

2014 ◽

Vol 270 (1) ◽

pp. 159-167 ◽

Cited By ~ 58

Author(s):

Yann Geffroy ◽

Isabelle Boulay-Coletta ◽

Marie-Christine Jullès ◽

Serge Nakache ◽

Patrice Taourel ◽

...

Keyword(s):

Small Bowel ◽

Small Bowel Obstruction ◽

Bowel Obstruction ◽

Bowel Wall ◽

Multidetector Ct

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Computer-Aided Detection of Small Bowel Strictures for Emergency Radiology in CT Enterography

Virtual Colonoscopy and Abdominal Imaging. Computational Challenges and Clinical Opportunities - Lecture Notes in Computer Science ◽

10.1007/978-3-642-25719-3_13 ◽

2011 ◽

pp. 91-97

Author(s):

Nisha I. Sainani ◽

Janne Näppi ◽

Dushyant V. Sahani ◽

Hiroyuki Yoshida

Keyword(s):

Small Bowel ◽

Emergency Radiology ◽

Computer Aided Detection ◽

Ct Enterography ◽

Computer Aided

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Radiology of the gastrointestinal tract

Oxford Textbook of Medicine ◽

10.1093/med/9780198746690.003.0288 ◽

2020 ◽

pp. 2748-2757

Author(s):

Fiachra Moloney ◽

Michael Maher

Keyword(s):

Nuclear Medicine ◽

Small Bowel ◽

Multidetector Ct ◽

Virtual Colonoscopy ◽

Gastrointestinal Disease ◽

Diagnostic Efficacy ◽

Cross Sectional ◽

Endoscopic Techniques ◽

Inflammatory Conditions ◽

Dimensional Reconstruction

The widespread introduction of endoscopic techniques has reduced the need for radiological examination of the intestinal tract and has almost completely rendered imaging of the stomach obsolete. There remains, however, a substantial role for radiological imaging in the investigation of the small and large bowel in the diagnosis of abdominal and gastrointestinal disease. The small intestine may be examined by a number of radiological techniques, including plain films, barium contrast studies, ultrasonography, CT, MRI, and nuclear medicine. Barium studies (follow-through or small-bowel enema) can provide good morphological detail of the mucosal surface of the bowel; cross-sectional imaging (usually CT or MRI) is required for disease in the wall of the bowel or outside it. CT is increasingly used as the primary investigation in suspected bowel obstruction. Nuclear medicine studies have a major role in the examination of the small bowel for the presence of inflammatory conditions, and for demonstration of potential bleeding sources. Colonoscopy has revolutionized imaging approaches to the colon because of its proven diagnostic efficacy and the added facility for biopsy of diffuse mucosal pathology and focal mucosal lesions, but is associated with a small risk of perforation. The use of barium enema continues to decline steadily. The advent of multidetector CT that allows three-dimensional reconstruction has led to a large number of new applications, including virtual colonoscopy or colonography, use of which is steadily increasing and is particularly valuable in the setting of unsuccessful or incomplete optical colonoscopy, although it is disadvantaged by inability to perform biopsy.

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Assessing Small Bowel Stricturing and Morphology in Crohn’s Disease Using Semi-automated Image Analysis

Inflammatory Bowel Diseases ◽

10.1093/ibd/izz196 ◽

2019 ◽

Vol 26 (5) ◽

pp. 734-742 ◽

Cited By ~ 3

Author(s):

Ryan W Stidham ◽

Binu Enchakalody ◽

Akbar K Waljee ◽

Peter D R Higgins ◽

Stewart C Wang ◽

...

Keyword(s):

Image Analysis ◽

Crohn’S Disease ◽

Small Bowel ◽

Crohn's Disease ◽

Structural Damage ◽

Clinical Decision Making ◽

Tertiary Care ◽

Automated Image Analysis ◽

Image Analysis System ◽

Ct Enterography

Abstract Background Evaluating structural damage using imaging is essential for the evaluation of small intestinal Crohn’s disease (CD), but it is limited by potential interobserver variation. We compared the agreement of enterography-based bowel damage measurements collected by experienced radiologists and a semi-automated image analysis system. Methods Patients with small bowel CD undergoing a CT-enterography (CTE) between 2011 and 2017 in a tertiary care setting were retrospectively reviewed. CT-enterography studies were reviewed by 2 experienced radiologists and separately underwent automated computer image analysis using bowel measurement software. Measurements included maximum bowel wall thickness (BWT-max), maximum bowel dilation (DIL-max), minimum lumen diameter (LUM-min), and the presence of a stricture. Measurement correlation coefficients and paired t tests were used to compare individual operator measurements. Multivariate regression was used to model identification of strictures using semi-automated measures. Results In 138 studies, the correlation between radiologists and semi-automated measures were similar for BWT-max (r = 0.724, 0.702), DIL-max (r = 0.812, 0.748), and LUM-min (r = 0.428, 0.381), respectively. Mean absolute measurement difference between semi-automated and radiologist measures were no different from the mean difference between paired radiologists for BWT-max (1.26 mm vs 1.12 mm, P = 0.857), DIL-max (2.78 mm vs 2.67 mm, P = 0.557), and LUM-min (0.54 mm vs 0.41 mm, P = 0.596). Finally, models of radiologist-defined intestinal strictures using automatically acquired measurements had an accuracy of 87.6%. Conclusion Structural bowel damage measurements collected by semi-automated approaches are comparable to those of experienced radiologists. Radiomic measures of CD will become an important new data source powering clinical decision-making, patient-phenotyping, and assisting radiologists in reporting objective measures of disease status.

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