Because of the active infusion, stenoses are more easily determined [43]. There have been few studies evaluating performance in recent years. 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/vasculature and surrounding inflammatory stranding [43,44]. Similar to CT enterography, the ability to detect even mild inflammation makes it useful in monitoring therapy. CT enteroclysis has been shown to be helpful in assessing the status of disease in CD patients post resection at the anastomosis [107]. However, the determination between active disease and fibrosis in a stricture remains difficult based on enhancement characteristics only [108]. Because CT enteroclysis is a cross- sectional imaging modality, assessment for alternative diagnoses as well for the possible complications of CD including obstruction, abscess, and fistula can be made [43]. Although CT enteroclysis represents one of the modalities with highest disease detection capabilities, the invasive nature with nasoduodenal tube insertion and active infusion of contrast may make it less favorable from a patient perspective, unless a mild stricture without definite proximal dilation is the clinical question and active distention is needed to confirm this stricture [9]. In addition, the need for repeated examinations over time makes this a less attractive choice in this clinical variant. CT Enterography CT enterography represents a CT examination with a specialized protocol. Neutral contrast by mouth is given in large amounts over a set time period to promote optimal distention of the small bowel [19-21].
Crohn Disease. Because of the active infusion, stenoses are more easily determined [43]. There have been few studies evaluating performance in recent years. 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/vasculature and surrounding inflammatory stranding [43,44]. Similar to CT enterography, the ability to detect even mild inflammation makes it useful in monitoring therapy. CT enteroclysis has been shown to be helpful in assessing the status of disease in CD patients post resection at the anastomosis [107]. However, the determination between active disease and fibrosis in a stricture remains difficult based on enhancement characteristics only [108]. Because CT enteroclysis is a cross- sectional imaging modality, assessment for alternative diagnoses as well for the possible complications of CD including obstruction, abscess, and fistula can be made [43]. Although CT enteroclysis represents one of the modalities with highest disease detection capabilities, the invasive nature with nasoduodenal tube insertion and active infusion of contrast may make it less favorable from a patient perspective, unless a mild stricture without definite proximal dilation is the clinical question and active distention is needed to confirm this stricture [9]. In addition, the need for repeated examinations over time makes this a less attractive choice in this clinical variant. CT Enterography CT enterography represents a CT examination with a specialized protocol. Neutral contrast by mouth is given in large amounts over a set time period to promote optimal distention of the small bowel [19-21].