| Objective: 50 patients who were suspected of having small-bowel dieases underment a noninvasive peroral MSCT enterography with isosmotic mannitol to estimate small-bowel distention and to investigate the superiority in clinical application to diseases of intestinal tract.Methods : After all patients were underment routined CT scanning, they were assigned to drink a total of 1,800ml(impuberism just taken 900ml) isosmotic mannitol in 75 minutes by four times prior to CT enterography in order to increase gastric and small bowel engorge. Each time was given 450ml. At the beginning the first aliquots was given to the patients and subsequent aliquots were given at 25, 50, and 65 minutes ;then inject the peristaltic agent(excluding who have bowel obstruction ). CT scanning was performed at 75 minutes after the first taken.50 patients were divided into impuberism groups, alduts groups,bowel obstruction groups(All patients with bowel obstruction were aldut.) and without bowel obstruction groups.Results1.Peroral MSCT enterography was well tolerated in 47 patients ;3 patients in adults who complained just taken 500ml.At MSCTE scanning the material contrast in 48 patients were reached the ileocecal junction.2.MSCTE with isosmotic mannitol can make the bowel luminal adequate distention. The 37 adult patients,who haven't bowel obstruction ,of luminal distention of jejunum was 19.3±3.9mm ,ileum was 16.1±5.3mm. 4 impuberism patients of luminal distention of jejunum was 17.2±3.6mm, ileum was 13.5±2.2mm. Distensibility of jejunum of patients who haven't bowel obstruction including the impuberism was better than ileum.3.MSCTE allowed the diagnosis of small-bowel masses (n = 15), active Crohn disease (n =3), bowel tuberculosis (n = 3), small-bowel lymphoma disease (n =5), colon carcinoma(n=8) ,normal findings (n=5 ) and other findings (n=11) (all including confirmed bowel obstruction n=9).4. Sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of MSCTE were 97.8 % ,100%, 98 % ,100% and 80%, respectively; But the regular MSCT scanning was 90.9%, 66.7%, 88%,95.2%,50%. The detection rate of the diseases of intestinal tract by MSCTE is higher than by regular MSCT .Conclusion :1. The method of Peroral MSCT enterography with isosmotic mannitol is simple which can adequately dialate the small bowel and easily find and display the pathological changes of digestive tract. It was better than the regular CT at diagnosising the diease in intestinal tract; it has great superiority especially in small-bowel diease.2. Peroral MSCT enterography also have important vaule in differential diagnosis of abdominal cavity diease. |
