Computed tomography of the bowel: a prospective comparison study between four techniques

Area of Science:

• Radiology and Imaging
• Gastroenterology

Background:

• Accurate visualization of the small and large intestines is crucial for diagnosing gastrointestinal conditions.
• Various computed tomography (CT) techniques exist for bowel imaging, each with potential advantages and disadvantages.

Purpose of the Study:

• To prospectively compare the effectiveness of four CT techniques in achieving bowel distension.
• To evaluate patient tolerance for each CT protocol.
• Techniques compared: CT enteroclysis (CTE), CT enterography (CTe), CT with water enema (CT-WE), and CTe with water enema (CTe-WE).

Main Methods:

• A prospective study involving 120 outpatients divided into four equal groups, each undergoing a specific CT protocol.
• Bowel distension was assessed quantitatively and qualitatively by two gastrointestinal radiologists.
• Patient tolerance and adverse effects were systematically recorded for each technique.

Main Results:

• CT enteroclysis (CTE) demonstrated superior jejunal loop distension (median diameter 27 mm) compared to other methods (p<0.0001).
• CT with water enema (CT-WE) and CTe-WE provided significantly greater and more consistent large intestine distension (p<0.0001).
• Adverse effects were most frequent in the CTE group (p<0.0028).

Conclusions:

• CT enteroclysis (CTE) offers optimal jejunal distension but is associated with the highest patient discomfort.
• CT with water enema (CT-WE) effectively distends the terminal ileum in a high percentage of patients.
• CTe-WE simultaneously achieves optimal distension of both the small and large bowel.