Maataoui Adel, Vogl Thomas J, Jacobi Volkmar, Khan M Fawad
Adel Maataoui, Thomas J Vogl, Volkmar Jacobi, M Fawad Khan, Institute for Diagnostic and Interventional Radiology, Goethe University, 60590 Frankfurt am Main, Germany.
World J Radiol. 2013 Jul 28;5(7):253-8. doi: 10.4329/wjr.v5.i7.253.
To retrospectively analyze changes in clinical indication, referring medical specialty and detected pathology for small bowel double-contrast examinations.
Two hundred and forty-one (n = 143 females; n = 98 males; 01.01.1990-31.12.1990) and 384 (n = 225 females; n = 159 males; 01.01.2004-31.12.2010) patients underwent enteroclysis, respectively. All examinations were performed in standardized double-contrast technique. After placement of a nasojejunal probe distal to the ligament of Treitz, radiopaque contrast media followed by X-ray negative distending contrast media were administered. Following this standardized projections in all four abdominal quadrants were acquired. Depending on the detected pathology further documentation was carried out by focused imaging. Examination protocols were reviewed and compared concerning requesting unit, indication and final report.
Two hundred and forty-one examinations in 1990 faced an average of 55 examinations per year from 2004-2010. There was an increase of examinations for gastroenterological (33.6% to 64.6%) and pediatric (0.4% to 7.8%) indications while internal (29.0% to 6.0% for inpatients and from 16.6% to 9.1% for outpatients) and surgical (12.4% to 7.3%) referrals significantly decreased. "Follow-up of Crohn's disease" (33.1%) and "bleeding/tumor search" (15.1%) represented the most frequent clinical indications. A total of 34% (1990) and 53.4% (2004-2010) examinations yielded pathologic findings. In the period 01.01.2004 -31.12.2010 the largest proportion of pathological findings was found in patients with diagnosed Crohn's disease (73.5%), followed by patients with abdominal pain (67.6% with history of surgery and 52.6% without history of surgery), chronic diarrhea (41.7%), suspected Crohn's disease (39.5%) and search for gastrointestinal bleeding source/tumor (19.1%). The most common pathologies diagnosed by enteroclysis were "changes in Crohn's disease" (25.0%) and "adhesions /strictures" (12.2%).
"Crohn's disease" represents the main indication for enteroclysis. The relative increase of pathologic findings reflects today's well directed use of enteroclysis.
回顾性分析小肠双重对比造影检查的临床指征、转诊医学专业及检出病变的变化。
分别有241例（143例女性；98例男性；1990年1月1日至1990年12月31日）和384例（225例女性；159例男性；2004年1月1日至2010年12月31日）患者接受了小肠灌肠造影检查。所有检查均采用标准化双重对比技术。在将鼻空肠探头放置在屈氏韧带远端后，先注入不透X线的造影剂，随后注入X线阴性的扩张性造影剂。在此之后，获取腹部四个象限的标准化投照影像。根据检出的病变，通过聚焦成像进行进一步记录。对检查方案进行回顾并比较请求科室、指征及最终报告。
1990年的241例检查平均每年有55例，2004年至2010年为384例检查。胃肠病学（从33.6%增至64.6%）和儿科（从0.4%增至7.8%）指征的检查有所增加，而内科（住院患者从29.0%降至6.0%，门诊患者从16.6%降至9.1%）和外科（从12.4%降至7.3%）转诊显著减少。“克罗恩病随访”（33.1%）和“出血/肿瘤排查”（15.1%）是最常见的临床指征。分别有34%（1990年）和53.4%（2004年至2010年）的检查发现了病理结果。在2004年1月1日至2010年12月31日期间，病理结果比例最高的是已确诊克罗恩病的患者（73.5%），其次是腹痛患者（有手术史的为67.6%，无手术史的为52.6%）、慢性腹泻患者（41.7%）、疑似克罗恩病患者（39.5%）以及排查胃肠道出血源/肿瘤患者（19.1%）。小肠灌肠造影最常诊断出的病变是“克罗恩病改变”（25.0%）和“粘连/狭窄”（12.2%）。
“克罗恩病”是小肠灌肠造影的主要指征。病理结果相对增加反映了如今小肠灌肠造影的针对性应用良好。
