What is CT Enterography?

CT enterography is a special type of computed tomography (CT) imaging performed with intravenous contrast material after the ingestion of liquid that helps produce high resolution images of the small intestine in addition to the other structures in the abdomen and pelvis.

Computed tomography, more commonly known as a CT or CAT scan, is a diagnostic medical imaging test. Like traditional x-rays, it produces multiple images or pictures of the inside of the body.

A CT scan generates images that can be reformatted in multiple planes. It can even generate three-dimensional images. Your doctor can review these images on a computer monitor, print them on film or via a 3D printer, or transfer them to a CD or DVD.

CT images of internal organs, bones, soft tissue, and blood vessels provide greater detail than traditional x-rays. This is especially true for soft tissues and blood vessels.

What are some common uses of the procedure?

Physicians use CT enterography to identify and locate:

• small bowel inflammation
• bleeding sources within the small bowel
• small bowel tumors
• abscesses and fistulas
• bowel obstruction.

CT enterography is also used to diagnose Crohn's disease, and determine its location, severity and unexpected complications, in order to guide effective treatment.

Who interprets the results and how do I get them?

A radiologist, a doctor specially trained to supervise and interpret radiology exams, will analyze the images. The radiologist will send an official report to the doctor who ordered the exam.

What are the benefits vs. risks?

Benefits

• CT scanning is painless, noninvasive, and accurate.
• A major advantage of CT is its ability to image bone, soft tissue, and blood vessels all at the same time.
• Unlike conventional x-rays, CT scanning provides very detailed images of many types of tissue as well as the lungs, bones, and blood vessels.
• CT exams are fast and simple. In emergency cases, they can reveal internal injuries and bleeding quickly enough to help save lives.
• CT has been shown to be a cost-effective imaging tool for a wide range of clinical problems.
• Compared to other imaging procedures of the small intestine, CT enterography is able to visualize the entire thickness of the bowel wall and to evaluate surrounding soft tissues. The other examinations, some of which are invasive, are only able to image the inner lining of the small intestine.
• CT enterography has been shown to diagnose and/or rule out certain conditions/diseases that could help determine your future medical care.
• CT enterography may eliminate the need for video capsule endoscopy (VCE) and the potential complications of that procedure.
• CT enterography allows other organs in the abdomen to be seen.
• CT is less sensitive to patient movement than MRI.
• Unlike MRI, an implanted medical device of any kind will not prevent you from having a CT scan.
• No radiation remains in a patient's body after a CT exam.
• The x-rays used for CT scanning should have no immediate side effects.

Risks

• There is always a slight chance of cancer from excessive exposure to radiation. However, the benefit of an accurate diagnosis far outweighs the risk involved with CT scanning.
• Women should always tell their doctor and x-ray or CT technologist if there is any chance they are pregnant. See the Radiation Safety page for more information about pregnancy and x-rays.
• Doctors do not generally recommend CT scanning for pregnant women unless medically necessary because of potential risk to the unborn baby.
• IV contrast manufacturers indicate mothers should not breastfeed their babies for 24-48 hours after contrast material is given. However, the most recent American College of Radiology (ACR) Manual on Contrast Media reports that studies show the amount of contrast absorbed by the infant during breastfeeding is extremely low. For further information please consult the ACR Manual on Contrast Media and its references.
• The risk of serious allergic reaction to contrast materials that contain iodine is extremely rare, and radiology departments are well-equipped to deal with them.
• Advancements in CT technology now allow CT enterography to be performed with even lower radiation doses.

What are the limitations of CT Enterography?

A person who is very large may not fit into the opening of a conventional CT scanner. Or, they may be over the weight limit—usually 450 pounds—for the moving table.

Certain bowel obstructions, small tumors and early inflammation may not be visualized with CT enterography. Another procedure, CT enteroclysis, provides greater filling and distension of the small intestine and may allow better detection of abnormalities. However, it requires placement of a tube into the small bowel through the nose.