Utility of CT enterography in the evaluation of small bowel pathologies

Ravi U. Varma, Kishor L. Rajpal, Nilesh R. Bite, Dev S. Shetty


Background: Radiology has been the primary investigation tool for small intestine because of technical challenges in endoscopy. Barium studies and computed tomography (CT) have been the most useful modalities over the years; however, neither is a complete investigation by itself. CT enterography offers the possibility of a single comprehensive radiological evaluation. The present study was undertaken to study the accuracy of CT enterography in characterising various small bowel pathologies.

Methods: A total of 84 patients clinically suspected or known to have small intestinal disease underwent CT enterography on a 64 slice MDCT. The radiologic findings were correlated with clinical, endoscopy, histopathology and operative findings.

Results: A wide variety of pathologies can be diagnosed accurately on CT enterography. In our study, majority of the patients had non-neoplastic pathologies (79%). Neoplastic lesions were detected in 21% of the patients of which 14% were malignant. There was good correlation between CT enterography and endoscopy, histopathology and operative findings. The ability of CT enterography to differentiate acute inflammation from chronic changes is valuable in management of Crohn’s disease.

Conclusions: CT enterography should be considered as the investigation of choice for radiological evaluation of small bowel pathologies as it provides a comprehensive evaluation of the disease process.


Computed tomography, Enterography, Small bowel

Full Text:



Masselli G. Small Bowel Imaging: Clinical Applications of the different Imaging Modalities - A Comprehensive Review. ISRN Pathol. 2013;Article ID 419542:13.

Raptopoulos V, Schwartz RK, Menicholas MM, Movson J, Pearlman J, Joffe N. Multiplanar helical CT enterography in patients with Crohn’s disease. Am J Roentenol. 1997;169:1545-50.

Macari M, Megibow AJ, Balthazar EJ. A pattern approach to the abnormal small bowel: observations at MDCT and CT enterography. Am J Roentgenol. 2007;188(5):1344-55.

Ilangovan R, Burling D, George A, Gupta A, Marshall M, Taylor SA. CT enterography: review of technique and practical tips. Br J Radiol. 2012;85(1015):876-86.

Macari M, Balthazar EJ. CT of bowel wall thickening: significance and pitfalls of interpretation. Am J Roentgenol. 2001;176(5):1105-16.

Hara AK, Swartaz PG. CT enterography of crohn’s disease. Abdom Imaging. 2009;34:289-95.

Tye GA, Desser TS. MDCT of the small bowel. Appl Radiol. 2012;41(8);6-17.