Abstract
Purpose
The aim of this study was to assess the diagnostic potential of multidetector computed tomography (MDCT) in the evaluation of small-bowel neoplasms.
Materials and methods
We studied 120 patients with suspected small-bowel disease by 16-slice MDCT after oral administration of a polyethylene glycol solution (n=56) or methylcellulose via a nasojejunal tube (n=64). Unenhanced and contrast-enhanced CT was performed. Contrast-enhanced CT images were acquired 40 s after IV injection of 130 ml of iodinated contrast agent at a rate of 3 ml/s. Multiplanar reconstructions were performed at the end of the examinations.
Results
Fifteen patients were found to be affected by small-bowel neoplasm (six had non-Hodgkin’s lymphoma, three had carcinoid tumour, two had Peutz-Jeghers syndrome, two had adenocarcinoma, two had melanoma metastases, one had lipoma). In the remaining patients, 58 cases of Crohn’s disease and seven miscellaneous diseases were detected. All findings were confirmed by barium studies, surgery or endoscopy.
Conclusions
MDCT performed after bowel-loop distension with low-density contrast material and IV administration of iodinated contrast agent is a reliable method for diagnosing and staging small-bowel neoplasms.
Riassunto
Obiettivo
Valutare le potenzialità diagnostiche della TC multidetettore nello studio delle neoplasie dell’intestino tenue.
Materiali e metodi
Sono stati studiati 120 pazienti con sospetta patologia tenuale mediante TC multidetettore (16 strati) previa somministrazione di polietilenglicole per via orale (n=56) o di metilcellulosa attraverso sondino naso-digiunale (n=64). L’esame TC è stato eseguito prima e durante infusione di 130 ml di MdC iodato con flusso di 3 ml/s ed inizio delle scansioni dopo 40 secondi dall’inizio della somministrazione. Al termine dell’esame sono state effettuate ricostruzioni multiplanari.
Risultati
Quindici pazienti sono risultati affetti da neoplasia dell’intestino tenue (6 pazienti con linfoma non Hodgking, 3 con carcinoide, 2 con sindrome di Peutz Jeghers, 2 con adenocarcinoma, 1 con metastasi da melanoma e 1 con lipoma). In 58 pazienti la diagnosi era di morbo di Crohn, in 7 pazienti erano presenti patologie varie. Tutti i quadri venivano confermati con studi baritati, intervento chirurgico o endoscopia.
Conclusioni
La TC multidetettore effettuata previa distensione delle anse con MdC ipodenso ed infusione ev di MdC iodato è una metodica utile nella diagnosi e stadiazione delle neoplasie tenuali.
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Minordi, L.M., Vecchioli, A., Mirk, P. et al. Multidetector CT in small-bowel neoplasms. Radiol med 112, 1013–1025 (2007). https://doi.org/10.1007/s11547-007-0202-0
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DOI: https://doi.org/10.1007/s11547-007-0202-0