Computed tomography enterography for evaluation of inflammatory bowel disease

Area of Science:

• Gastroenterology
• Radiology
• Medical Imaging

Background:

• Computed tomography enterography (CTE) is a primary imaging modality for evaluating inflammatory bowel disease (IBD).
• CTE provides simultaneous visualization of the small bowel and extraintestinal manifestations crucial for IBD diagnosis.
• Distinguishing between different types of IBD is essential for appropriate patient management.

Purpose of the Study:

• To review the characteristic findings of various inflammatory bowel diseases on CTE.
• To highlight the utility of CTE in the differential diagnosis of IBD.
• To discuss the limitations of CTE, including radiation exposure, and advancements in dose reduction.

Main Methods:

• Review of characteristic CTE findings for Crohn disease, intestinal tuberculosis, and intestinal Behcet disease.
• Analysis of imaging features such as wall thickening, enhancement patterns, vascularity, and ulceration.
• Discussion of the role of CTE in differentiating between these IBDs.

Main Results:

• Crohn disease shows long segmental enhancing wall thickening, mural stratification, fibrofatty proliferation, comb sign, and fistulas.
• Intestinal tuberculosis presents with short segmental thickening and central low-attenuated lymph nodes.
• Intestinal Behcet disease is characterized by geographic, deep ulcers and mural hyperenhancement in the ileocecal area.

Conclusions:

• CTE findings are valuable for differentiating between various types of IBD.
• CTE plays a key role in the diagnosis and management of IBD.
• Ongoing advancements in CT technology aim to reduce radiation dose for patients undergoing CTE for IBD evaluation.