CT enterography

Computed tomographic (CT) enterography is a non-invasive technique for diagnosis of small bowel disorders.

  • evaluates the entire thickness of the bowel wall
  • offers information about the surrounding mesentery, the mesenteric vasculature and the perienteric fat
  • detect occult gastrointestinal tract bleeding, 
    small bowel neoplasms, and mesenteric ischemia.
  • useful in the assessment of the solid organs and provides global overview of the abdomen 1
  • exposure to ionizing radiation

Adequate luminal distension is necessary as collapsed bowel loops may mimic pathology. CT enterography utilizes negative or neutral oral contrast:

  • neutral or negative oral contrast agents 1-3
    • these have attenuation similar to that of water e.g. water, PEG, mannitol, methyl cellulose, locust bean gum and low density barium sulfate preparations (Volumen, 0.1% W/V) 
    • intravenous contrast is used with neutral agents
    • these agents allow better assessment of mucosal enhancement, mural thickness as well as mesenteric vasculature, this is important especially in the evaluation of Crohn disease 2

Actual procedure will vary depending on institutional protocol/guidelines but below is a typical description 1,2:

  1. abstain from all food and drink 4-6 hours before the exam
  2. patients drink about 1.5 L of oral contrast over 30-60 minutes
  3. administration of intravenous contrast injection at a rate 4 mL/sec
  4. CT scanning is ideally performed on a multi-detector computed tomography (MDCT) scanner about 50 seconds after contrast material injection in a single enteric phase where peak mucosal enhancement is achieved and can include venous phase or arterial and venous phases for the evaluation of mesenteric vasculature
  5. in cases of suspected GI bleeding pre-contrast, arterial (20-25 s), portal venous (70 s) and delayed (150 s) should be considered
    • positive oral contrast is contraindicated
  6. data interpretation with the use of axial and coronal reformatted images for proper evaluation
CT examinations
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Article information

rID: 30358
Section: Approach
Synonyms or Alternate Spellings:
  • Computed tomographic (CT) enterography

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Cases and figures

  • Case 1: normal CT enterography arterial phase
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  • Case 1: portal venous phase
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  • Case 2: Crohn disease
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  • Case 3: Crohn disease
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  • Case 4: Crohn disease with small bowel obstruction
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