Department of Gastroenterology and Hepatology, Box Hill Hospital, Melbourne, Victoria, Australia.
Intern Med J. 2009 Nov;39(11):733-43. doi: 10.1111/j.1445-5994.2008.01843.x. Epub 2008 Nov 11.
Computed tomography enteroclysis (CTE) may be superior to other small bowel imaging techniques, detecting subtle mucosal lesions and extraluminal pathology. This study aimed to define the technical success, clinical influence and tolerance of CTE in patients with suspected small bowel disease.
CTE scans of 42 consecutive patients (aged 21-78 years, 12 men) were reviewed by a single radiologist for technical adequacy and diagnosis. A panel of gastroenterologists reviewed clinical information. At a telephone interview, tolerance of CTE was graded numerically from 1 (unbearable) to 10 (excellent) and descriptively as unbearable, fair, good or excellent.
Good or optimal distension of small bowel was achieved in 98%. The entire small bowel was imaged in 88%. Eighteen patients had a normal small bowel, whereas 12 (29%) had active small bowel Crohn disease, 4 intussusception, 3 small bowel diverticula and 7 having other diagnoses. Mesenteric lymphadenopathy was evident in 11 and fat stranding in 5. CTE resulted in a new or altered diagnosis in 13 (31%) patients and identified more extensive Crohn disease in a further 8 (19%). A change in management plan was instituted in 18 (43%) patients, with subsequent clinically significant improvement in 12. 33 (85%) described the procedure as 'fair' or 'unbearable' rather than 'good' or 'excellent'. The median tolerance score was 3 out of 10.
CTE provided high-quality images in nearly all patients and had an effect on diagnosis, management or outcome in most, but was not well tolerated.
计算机断层肠造影（CTE）可能优于其他小肠成像技术，可检测细微的黏膜病变和腔外病变。本研究旨在确定疑似小肠疾病患者的 CTE 技术成功率、临床影响和耐受性。
由一名放射科医生对 42 例连续患者（年龄 21-78 岁，12 名男性）的 CTE 扫描进行了回顾性分析，以评估技术的充分性和诊断。一组胃肠病学家对临床信息进行了回顾。在电话采访中，患者根据可耐受程度对 CTE 进行了数字评分（1 分为无法忍受，10 分为极好）和描述性评分（无法忍受、尚可、良好或极好）。
98%的患者小肠得到了良好或最佳的扩张。88%的患者可对整个小肠进行成像。18 例患者的小肠正常，12 例（29%）患有活动性小肠克罗恩病，4 例肠套叠，3 例小肠憩室，7 例其他诊断。11 例患者肠系膜淋巴结肿大，5 例患者脂肪条纹。CTE 导致 13 例（31%）患者出现新的或改变的诊断，并进一步确定 8 例（19%）患者患有更广泛的克罗恩病。18 例（43%）患者制定了治疗计划的改变，随后 12 例患者的临床状况显著改善。33 例（85%）患者认为该过程“尚可”或“无法忍受”，而不是“良好”或“极好”。患者的耐受评分中位数为 10 分中的 3 分。
CTE 为几乎所有患者提供了高质量的图像，对大多数患者的诊断、治疗或预后产生了影响，但患者的耐受性较差。
