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CT Enterography is an examination targeted to the small bowel. It replaces other small bowel studies such as a small bowel follow through under fluoroscopy. It is sensitive for detection of inflammatory bowel disease or small bowel masses. Outside of the bowel, it provides that same information as a conventional contrast enhanced CT. It is excellent for depiction of extraluminal pathology including abscesses and free intraperitoneal air from bowel perforation.
It is not a replacement for upper or lower endoscopy. Bowel motility is not evaluated, and MR Enterography may be a more suitable exam in some patients.
Exam is optimal for patients with suspected inflammatory bowel disease or small bowel masses, especially as a first test and as a substitute for a conventional CT. It may permit evaluate gastric and colonic mucosa, but is not as sensitive as endoscopy or virtual colonoscopy for this purpose.
Serial scans increase radiation dose—a potential issue in young patients with Crohn’s disease. MR Enterography may be a more appropriate exam for serial follow up.
Use CT Enterography instead of MRE for:
Use MR Enterography instead of CTE for:
Please specify “CT Enterography Abdomen and Pelvis” when prescribing. Patients do not receive standard positive (barium) oral contrast, but instead receive a negative oral contrast agent at the time of the exam. This negative contrast agent distends the bowel and permits detection of mucosal enhancement.
Patient should be NPO for 4 hours prior to the procedure.
These exams require IV contrast to evaluate the mucosa of the stomach, small bowel and colon. Standard precautions with regard to IV iodinated contrast are necessary. If iodinated contrast is contraindicated, there is no role for CTE. MR enterography, either without or preferably with gadolinium, may be considered as an alternative.
CTE is excellent at depicting early changes of IBD and documenting complications such as abscess or fistula. As the abdomen and pelvis are both imaged in their entirety during a CTE, unrelated pathology in other organs may often be detected.
Every CT enterography exam is reviewed by a board certified radiologist with subspecialty training in advanced body imaging. A comprehensive report detailing findings in the abdomen, pelvis, and in the bowel is provided to the referring clinician. If urgent findings are encountered, these are relayed in real time by telephone. A copy of the examination and report is furnished to the patient upon request. The exam may also be reviewed directly with the radiologist in the radiology department at a Wellstar facility.