Because of the active infusion, stenoses are more readily determined [43]. There have been few studies evaluating performance in recent years. Although bowel distention of the jejunum is improved with CT enteroclysis, the distention at CT enterography is considered acceptable [17,18], and CT enterography has been more generally utilized over CT enteroclysis because the procedure is better tolerated by patients. As with all imaging modalities, it is difficult to precisely determine the test characteristics in CD exactly because of the lack of a true reference standard. However, the overall diagnostic performance for CT enteroclysis is excellent (ie, >85% sensitivity, >90% specificity) [45-47], and this examination has been used as a reference standard for other modalities in various studies [41,47]. The diagnosis of acute inflammation is made through visualization of thickened small bowel with mural stratification as well as extraenteric processes, including engorged vasa recti/vascular and surrounding inflammatory stranding [43,44]. Because CT enteroclysis is a cross- sectional imaging modality, assessment for alternative diagnoses as well as for the possible complications of CD, including obstruction, abscess, and fistula, can be made [43]. Although the bowel optimization at CT enteroclysis allows excellent examination performance, equivalent to highest-performing modalities, CT enteroclysis is not typically suitable in the acute setting in which the patient is ill. It is not uncommon that they cannot tolerate the requirements of this somewhat invasive examination. In a scenario in which the CD is a diagnostic consideration among others without a prior established diagnosis of inflammatory bowel disease, the discomfort and risks of duodenal intubation and active contrast infusion often outweighs the increased diagnostic performance gained, arguing against its use in this situation. Crohn Disease
Crohn Disease. Because of the active infusion, stenoses are more readily determined [43]. There have been few studies evaluating performance in recent years. Although bowel distention of the jejunum is improved with CT enteroclysis, the distention at CT enterography is considered acceptable [17,18], and CT enterography has been more generally utilized over CT enteroclysis because the procedure is better tolerated by patients. As with all imaging modalities, it is difficult to precisely determine the test characteristics in CD exactly because of the lack of a true reference standard. However, the overall diagnostic performance for CT enteroclysis is excellent (ie, >85% sensitivity, >90% specificity) [45-47], and this examination has been used as a reference standard for other modalities in various studies [41,47]. The diagnosis of acute inflammation is made through visualization of thickened small bowel with mural stratification as well as extraenteric processes, including engorged vasa recti/vascular and surrounding inflammatory stranding [43,44]. Because CT enteroclysis is a cross- sectional imaging modality, assessment for alternative diagnoses as well as for the possible complications of CD, including obstruction, abscess, and fistula, can be made [43]. Although the bowel optimization at CT enteroclysis allows excellent examination performance, equivalent to highest-performing modalities, CT enteroclysis is not typically suitable in the acute setting in which the patient is ill. It is not uncommon that they cannot tolerate the requirements of this somewhat invasive examination. In a scenario in which the CD is a diagnostic consideration among others without a prior established diagnosis of inflammatory bowel disease, the discomfort and risks of duodenal intubation and active contrast infusion often outweighs the increased diagnostic performance gained, arguing against its use in this situation. Crohn Disease