CT of the small intestine

CT of the small intestine continues to be a diagnostic challenge. Three protocols have turned out to be useful. The frequently used general protocol is highly suitable for most indications that require an overview of the small intestine and in cases where no specific queries regarding the small intestine have to be answered. A dedicated protocol with opacification of the small intestine by means of a probe appears to be useful in patients with a suspected tumour or to exclude a tumour as well as in cases of inflammatory bowel disease. Filling of the bowel ensures optimal distention and, in combination with intravenous contrast medium administration, allows differentiation of tumours from inflammatory lesions. In cases of suspected intestinal ischaemia, angiographic techniques should be used. State-of-the-art techniques such as bolus tracking and acquisition of a dynamic scan for determination of individual circulation time facilitate optimal arterial opacification of the intestinal wall. The results obtained in our patients suggest that the use of multislice CT in combination with optimal opacification improves sensitivity. Further studies have to show whether the improved diagnostic options also translate into an improved clinical outcome or survival rate.