Department of Radiology, "Luigi Sacco" University Hospital, Via G.B. Grassi 74, 20157, Milan, Italy,
Insights Imaging. 2013 Jun;4(3):309-20. doi: 10.1007/s13244-013-0239-7. Epub 2013 Mar 19.
Water enema multidetector computed tomography (WE-MDCT) is currently considered the most accurate imaging modality to provide high-resolution multiplanar visualisation of the colonic wall and surrounding structures.
This pictorial review presents our experience with WE-MDCT applications outside colorectal tumour staging, particularly for investigating diverticular disease and chronic inflammatory bowel diseases. A detailed explanation of the technique is provided, including patient preparation, the acquisition protocol, and study interpretation.
WE-MDCT allows accurate preoperative visualisation of diverticular disease, acute and complicated diverticulitis. Ulcerative, indeterminate, or Crohn's colitis can be assessed including longitudinal distribution, mural thickening and enhancement patterns, pseudopolyps, associated perivisceral changes, adjacent organ involvement, and features suggesting carcinoma. Elective WE-MDCT represents a useful complementary technique in patients with impossible, incomplete, or inconclusive endoscopy, can allow study of a stricture's features and the upstream bowel, and helps planning medical, endoscopic, or surgical treatments.
Urgent WE-MDCT with limited or no bowel preparation may prove useful in acutely symptomatic patients, as it may obviate a risky or contraindicated endoscopy, can determine disease severity, and allows making correct therapeutic choices.
• Water enema multidetector CT provides high-resolution multiplanar visualisation of the colonic wall. • WE-MDCT allows accurate visualisation of diverticular disease, acute and complicated diverticulitis. • In chronic inflammatory bowel diseases WE-MDCT depicts the distribution, mural and perivisceral changes. • Elective WE-MDCT usefully complements incomplete endoscopy to assess strictures and upstream colon. • Urgent WE-MDCT with limited or no bowel preparation in acute diseases may obviate endoscopy.
水灌肠多排 CT（WE-MDCT）目前被认为是提供结肠壁和周围结构高分辨率多平面可视化的最准确成像方式。
本影像学综述介绍了我们在结直肠肿瘤分期以外应用 WE-MDCT 的经验，特别是用于研究憩室病和慢性炎症性肠病。详细解释了技术，包括患者准备、采集方案和研究解释。
WE-MDCT 允许准确地对憩室病、急性和复杂的憩室炎进行术前可视化。溃疡性、不确定或克罗恩结肠炎可进行评估，包括纵向分布、壁增厚和增强模式、假息肉、相关的肠系膜变化、相邻器官受累和提示癌的特征。选择性 WE-MDCT 是一种有用的补充技术，适用于内镜检查不可行、不完整或不确定的患者，可对狭窄的特征和上游肠进行研究，并有助于制定医疗、内镜或手术治疗计划。
在有症状的急性患者中，进行有限或无肠道准备的紧急 WE-MDCT 可能会证明有用，因为它可以避免风险或禁忌的内镜检查，确定疾病的严重程度，并允许做出正确的治疗选择。
水灌肠多排 CT 提供结肠壁的高分辨率多平面可视化。
WE-MDCT 可准确显示憩室病、急性和复杂的憩室炎。
在慢性炎症性肠病中，WE-MDCT 描述了分布、壁和肠系膜的变化。
选择性 WE-MDCT 可有效地补充不完全的内镜检查，以评估狭窄和上游结肠。
在急性疾病中，进行有限或无肠道准备的紧急 WE-MDCT 可能会避免内镜检查。
