Role of Multi-Detector CT (MDCT) in Evaluation of Bowel Diseases

Multi-Detector Computed Tomography (MDCT) has revealed excellent results in various systems of the body. Its role in abdominal imaging for solid viscera has been proved beyond doubt. It is an emerging non invasive tool for evaluation of bowel diseases.

To see the efficacy of MDCT in evaluation of various bowel diseases.

The study was carried out in the Department of Radiodiagnosis and Imaging, Batra Hospital and Medical Research Centre, Delhi, India. A total of 60 patients were enrolled in this study from March 2008 to June 2010 over a period of 24 months. All patients suspected to have inflammatory, obstructive, ischaemic and neoplastic diseases of small or large bowel disease were included in the study. The patients with past history of chronic renal failure, allergic reaction to contrast were excluded from the study. Comparison was made between CT findings with the operative findings, endoscopy, angiography or histopathology correlation whichever was relevant with case. All this data was compiled and statistically analysed.

Out of 60 patients 12 patients were diagnosed having appendicitis using axial, Multiplaner Reconstruction (MPR) and curved MPR images. The findings of appendicitis were confirmed on surgery and subsequent histopathology correlation. Inflammatory bowel diseases comprised of 28 cases out of which seven persons were diagnosed with intestinal Koch's disease. Four patients had idiopathic inflammatory bowel diseases. Rest of the 17 patients were reported to have findings of non-specific colitis and they responded well with antibiotic treatment.

The sensitivity and specificity of MDCT in case of bowel obstruction clearly demonstrates not only the site of obstruction, but also reveal the cause of obstruction which includes intraluminal, intramural and extrinsic factors. CT scan categorizes the lesion to inflammatory or neoplastic to a greater accuracy. MDCT can also demonstrate the complications associated with obstruction like strangulation and perforation. CT is now considered a good tool in the evaluation of patients with suspected bowel obstruction, particularly in indeterminate clinical and conventional radiographic findings.