Study Of Multi-Slice Computed Tomography Enterography (MSCTE) In Clinical Application

Part ? The optimization of oral contrast agents in MSCTEObjective: To observe appropriate oral contrast agents for multi-slice CT enterography, through the comparison of the grade of bowel distension obtained with three different oral contrast agents?Materials and methods: Forty-five volunteers(22 women,23 men, aged 56.82 ±11.67 years) were randomly divided into three groups. The first group of 15 patients oraled 500 ml 20% osmotic mannitol and 1000 ml water; 15 patients in the second group oraled 1500 ml water; the third group of 15 cases taked 500 ml positive oral contrast agent and 1000 ml water. 20 mg 654-2 administered intramuscular injection 10 minutes prior to scanning.All volunteers underwent pre-contrast and delayed phase CT examinations of the abdomen and pelvis. All CT examinations were reviewed on a dedicated workstation(Neusoft PACS Systems), using the 1.5 mm thickness reconstructed images to obtain multi planar reconstructions(MPR) and maximum intensity projection(MIP).CT studies were reviewed in consensus by two abdominal radiologists who performed the analysis of bowel distension.Results: Isotonic mannitol solution provided the best distension of small intestine(3.47±0.64)when compared to all the other techniques(p = 0.000).Conclusions: Isotonic mannitol solution is a good oral intestinal contrast agent.Part? The investigation of the normal imaging findings in MSCTEObjective: To investigate the normal imaging findings of MSCTE by scan the small intestine obtained with isotonic mannitol solution.Materials and methods: Thirty MSCTE examinations were performed. Among them, eighteen were female, twelve were men, mean age was 56.87± 12.53 years. All volunteers oral 500 ml 20% osmotic mannitol and 1000 ml water 45 minutes prior to scanning and 20 mg 654-2 administered intramuscular injection 10 minutes prior to scanning.They underwent pre-contrast and delayed phase CT examinations of the abdomen and pelvis. All CT examinations were reviewed on a dedicated workstation(Neusoft PACS Systems), using the 1.5 mm thickness reconstructed images to obtain multi planar reconstructions(MPR) and maximum intensity projection(MIP).CT studies were reviewed in consensus by two abdominal radiologists who performed a quantitative and qualitative analysis of the images. The wall thickness and outer diameters of duodenum, jejunum and ileum were measured and the CT values of bowel wall in different phase were measured with a ROI of 2 mm2.Results: The normal wall thickness and outer diameter of small bowel were 2.09±0.41 mm and 2.13±0.36 cm respectively. CT values of bowel wall in pre-contrast and delayed phase were 38.32±6.40 HU and 80.74±10.68 HU. The data of normal MSCTE are consistent with relevant literature.Conclusions: The data can be used as a reference index to evaluate the small intestine. PART ? Study of MSCTE obtained with isotonic mannitol solution in Clinical ApplicationPurpose: To discuss the utility of MSCTE obtained with isotonic mannitol solution for evaluating the small intestinal diseases.Materials and methods: 85 patients(male 42; female 43; mean age 51.05±16.66 years) with symptoms of suspected small bowel diseases underwent pre-contrast and delayed phase CT examinations of the abdomen and pelvis. All CT examinations were reviewed on a dedicated workstation(Neusoft PACS Systems), using the 1.5 mm thickness reconstructed images to obtain multi planar reconstructions(MPR) and maximum intensity projection(MIP).Pertinent MSCTE and histopathology reports were reviewed. The imaging findings of small intestine neoplasms, inflammatory intestinal disease and other conditions affecting the small intestine were described and illustrated in detail. Related complications and extraenteric manifestations were also described.Results: Ninety-five MSCTE examinations were performed, the sensitivity of visual assessment for small intestine neoplasms and inflammatory intestinal disease were 85.71%?100%, the specificity were 95.24%?83.33%,the positive predictive values were 85.71%?91.89%,the negative predictive values were 95.24%?100%,the accuracy were 92.86%?94.23%, respectively.Conclusion: MSCTE obtained with isotonic mannitol solution and intravenous contrast material is useful in assessing small intestinal diseases.