Revista argentina de radiología
version ISSN 1852-9992
LALANNE, María Alejandra et al. CT enterography in Crohn's disease. Rev. argent. radiol. [online]. 2012, vol.76, n.3, pp. 229-239. ISSN 1852-9992.
Learning Objectives. To define the contribution of CT enterography (CTE) to the diagnosis, follow-up and prognosis of Crohn's disease, and to detail image acquisition. To compare CT enterography with other diagnostic methods used for the study of the small bowel, defining advantages and disadvantages. Topic Review. Crohn's disease is a chronic inflammatory bowel disease that affects the entire gastrointestinal tract with a discontinuous and transmural compromise. The objectives are to determine small bowel involvement, diagnosis of active disease and its response to treatment. The course of disease, its complications (bleeding, obstruction, strangulation, abscesses and fistulas) and the severity of symptoms are variable. Initial diagnosis is based on a combination of clinical, endoscopic, biochemical and radiological findings. Image Findings. The characteristic features in CTE are increased mural enhancement and enhanced lymph nodes after the administration of IV contrast (both signs of activity), wall thickening and halo sign (low attenuation ring in bowel due to deposit of submucosal fat), proliferation of mesenteric fat, prominence of the vasa recta, areas of stenosis, fistulas and abscesses. Conclusion. CTE is readily available and easy to perform, being possible to determine the extent and stage of disease progression, extraintestinal involvement and potential complications. The combination of a short examination time, a single breath hold, accessibility and availability has made CTE an important tool in the diagnosis and follow-up of patients with Crohn's disease.
Keywords : Tomography; Virtual colonoscopy; Ultrasound; Doppler; Crohn's disease; Inflamatory bowel disease.