University of Stellenbosch, Tygerberg Hospital, 4th Floor Radiology, Fransie van Zijl Avenue, Tygerberg, Cape Town 7505, South Africa.
Eur J Radiol. 2013 Aug;82(8):e317-25. doi: 10.1016/j.ejrad.2013.03.018. Epub 2013 May 8.
Imaging and diagnosis of small bowel disease is challenging, especially in developing countries where access to supplementary imaging equipment is not readily available. Imaging of the small bowel has evolved from small bowel follow-through to the first enteroclysis by Pesquera in 1929. This technique evolved over time with advances in enteral intubation catheters, enteral contrast media and techniques for infusing enteral contrast.
(1) Describe our modification of performing CTE and (2) to show pathology and discuss its relevance in our clinical practice.
This was a retrospective study that included 73 patients since the introduction of our modified technique of performing CT enteroclysis (CTE) using saline vaculitres, intravenous line connection sets and a drip stand. We recorded patient data in Microsoft Corporation Excel 2007 to include indications for the CTE, patient demographics and imaging findings related to small bowel pathology with associated extra luminal findings and incidental extra-intestinal non small bowel findings that was statistically analyzed.
Of the 73 patients included in the study 42 where females and 31 males. 15 (20.5%) had small bowel pathology and 12 (16.4%) had non-small bowel pathology that could explain the clinical symptoms. Malabsorption/chronic diarrhea group was the largest indication for referral (26% of referrals). Most prevalent small bowel findings were in the inflammatory bowel subgroups where 30% had imaging features of active inflammatory bowel disease.
Decades of experience have shown that only small bowel examinations that uniformly distend the small bowel lumen can confidently confirm or rule out small bowel pathology. With our modified technique performed, with readily available and affordable infusion equipment and enteral contrast we achieve diagnostic quality small bowel distention to demonstrate and diagnose with confidence small bowel pathology in our population. This is of particular value in developing countries where we are resource limited and expensive equipment and contrast material is often not available.
小肠疾病的影像学诊断具有挑战性，尤其是在发展中国家，那里难以获得补充影像学设备。小肠的影像学检查从小肠造影发展到 1929 年 Pesquera 进行的第一次肠造影术。随着肠内插管导管、肠内造影剂和肠内造影剂输注技术的进步，该技术不断发展。
（1）描述我们对 CTE 的改进，（2）展示病理学并讨论其在我们临床实践中的相关性。
这是一项回顾性研究，包括自我们使用盐水真空管、静脉连接套件和滴注架引入改良 CT 肠造影术（CTE）以来的 73 名患者。我们在 Microsoft Corporation Excel 2007 中记录患者数据，包括 CTE 的适应证、患者人口统计学特征以及与小肠病理学相关的影像学发现，包括相关的腔外发现和偶然的非小肠肠外发现，并进行了统计学分析。
在研究中纳入的 73 名患者中，有 42 名女性和 31 名男性。15 名（20.5%）有小肠病理学，12 名（16.4%）有非小肠病理学，可解释临床症状。吸收不良/慢性腹泻组是转诊的最大指征（转诊的 26%）。最常见的小肠发现是在炎症性肠病亚组中，其中 30%的患者有活动期炎症性肠病的影像学特征。
几十年的经验表明，只有均匀扩张小肠腔的小肠检查才能有信心地确认或排除小肠病理学。通过我们进行的改良技术，使用现成且负担得起的输注设备和肠内造影剂，我们可以获得诊断质量的小肠扩张，以有信心地诊断我们人群中的小肠病理学。在资源有限且昂贵的设备和造影剂通常不可用的发展中国家，这具有特别重要的价值。
