Desmoid Tumor Associated With Familial Adenomatous Polyposis: Evaluation With 64-Detector CT Enterography

The efficacy of new oral contrast mixture for computed tomography enterography

Purpose

To show the reliabilities of the new mixture (composed of water, methylcellulose, lactulose, locust bean gum, and sorbitol) and to compare the luminal distension and radiological confidence scores of this solution with water-lactulose mixture.

Material and methods

Computed tomography enterography (CTE) images in a three-year period were included randomly in our institutional review board-approved and retrospective study. Ninety-one patients drank a lactulose and water mixture (Group 1), and 54 patients drank the new mixture (Group 2). Patients who drank the oral contrast agent were taken to a 64-detector row multiple detector computed tomography machine. Coronal and sagittal reformatted images were also formed. The gastrointestinal tract was divided into 11 segments for scoring. Each segment was graded for distensional and radiological confidence. CTE images were evaluated by two radiologists.

Results

Inter- and intra-reader reliabilities were good or excellent for all gastrointestinal segments in both groups (p < 0.001). The best κ values were obtained in sigmoid colon assessments. Lower agreement values were detected in duodenum and jejunum scores. The new mixture group (Group 2) showed better results than Group 1 for ileum and colonic segments according to distension and confidence scorings.

Conclusions

Inter- and intra-reader reliabilities of the new mixture were good or excellent for CTE. The new mixture seems to be more efficient and reliable for ileum and colon. The new mixture can increase bowel distention, radiological confidence, and quality in CTE evaluations.

Evaluation of Enteroneovesical Fistula by 64-Detector CT Enterography: A Case Report

Enterovesical fistula is an abnormal communication between the bladder and the intestine. The accurate localization of leakage is important for accurate treatment planning. Some imaging techniques can not demonstrate the fistula; therefore, choosing the appropriate imaging technique is necessary. CT enterography (CTE) is a new technique for evaluation of the small bowel and the entire abdomen. CTE examination with multi-detector CT (MDCT) enables us to get excellent quality reformatted images with high spatial resolution. We report a patient with neobladder and enteroneovesical fistula. We showed the exact location of the fistula and its’ association with the bowels and neobladder by CTE. The aim of this report is to show that CTE can be a new and effective modality in the detection of enteroneovesical fistulas and to discuss the efficacy of CTE in the detection and evaluation of enterovesical fistula referring to the literature. In conclusion, CTE may be a useful, sensitive, effective, and non-invasive technique for the evaluation of enteroneovesical fistula, leakage from the anastomose sides, and other extraintestinal complications such as urinary tract obstruction or abscess formation.