Diseases of the small bowel can be challenging to diagnose. The symptoms of many small bowel conditions are similar, and conventional endoscopic procedures cannot visualize most areas of the small bowel or identify complications outside of the bowel wall. Conventional cross-sectional imaging often lacks sufficient sensitivity to identify important changes within the lumen and adjacent structures. Complete assessment of the small bowel requires high-resolution scanning of the entire length of the bowel and neighboring mesentery. Enterography combines multidetector computed tomography (CT) and magnetic resonance imaging (MRI) with oral and intravenous contrast to enhance intraluminal and adjacent bowel structures. The improved enhancement provides information with superior detail to permit a more accurate diagnosis. Inflammatory bowel disease and gastrointestinal bleeding are common indications for enterography, particularly when endoscopic results are negative or inconclusive. CT enterography (CTE) and MR enterography (MRE) are changing the way small-bowel pathology is diagnosed and treated. Choice of enterographic technique will depend on a number of patient, technical, and provider factors. Underlying the decision is the principle of producing images with sufficient diagnostic quality at the lowest possible radiation dose. Patient tolerance and acuity, the target of interest, and desire to limit exposure to ionizing radiation influence decision-making, but local preferences and availability play important roles. The radiologic technologist plays an integral role in carrying out the procedure in a way that adheres to this principle. This course will provide an overview of small-bowel anatomy, CTE, MRE, and their most common clinical applications.
After reading this article, the participant should be able to:
- Provide an overview of small-bowel anatomy.
- Describe the advantages and disadvantages of CTE in diagnosing small-bowel pathology.
- Describe the advantages and disadvantages of MRE in diagnosing small-bowel pathologydentify ways to reduce radiation exposure to staff.
- Identify common applications for CTE and MRE.
Categories: Computed Tomography, Magnetic Resonance Imaging