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[CT enteroclysis for detection of small bowel tumors]
C Orjollet-Lecoanet1, Y Ménard, A Martins
1Service de Radiologie digestive et interventionnelle, Pavillon H Radiologie, Hopital Edouard Herriot, Place d'Arsonval, 69437 Lyon Cedex 03.
Purpose:
To assess the feasibility and the usefulness of CT enteroclysis (helical CT with enteroclysis) in detecting small bowel tumors.
Materials And Methods:
Fifty patients were referred for suspicion of small bowel tumor. CT enteroclysis is performed by injecting a large volume of water using a pomp through a nasojejunal tube followed by a thin section helical acquisition.
Results:
Forty-eight helical CT enteroclysis were performed in order to detect 25 small bowel tumors. Among them 22 were confirmed by histological study. The mean size of tumors was 23 mm. In 12 of 17 cases, diagnosis was missed or incomplete at conventional barium study. Enteroscopy was performed in 12 of 22 cases, with discordant result in one case and incomplete result in 3 cases. In 8 cases, including 5 carcinoid tumors, patients had surgery after CT enteroclysis only, enteroscopy would probably have not made the diagnosis because the lesions were far from the duodenojejunal junction and ileocaecal valve.
Conclusion:
Helical CT enteroclysis is a new method for detecting small bowel tumors, easy to perform, well tolerated. It seems to be more sensitive than conventional barium studies and less invasive than enteroscopy. Tumor characterization and staging can be performed using a single examination. It seems to be justified to perform CT enteroclysis to detect small bowel tumors or in the evaluation of patients with polyposis.