Contribution of Multidetector Computed Tomography (MDCT) to Differential
Diagnostics of Intestine and Colon Inflammations
Ferda J., Mírka H., Kreuzberg B., Koželuhová J.1, Geiger J.2
Radiodiagnostická klinika LF UK a FN, Plzeň přednosta doc. MUDr. B. Kreuzberg, CSc.I. interní klinika LF UK a FN, Plzeň1přednosta prof. MUDr. K. Opatrný, DrSc.Chirurgická klinika LF UK a FN, Plzeň2přednosta prof. MUDr. V. Třeška, DrSc. |
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Summary:
The paper presents experience in the examination of intestine and colon inflammations over the
period of 12 months, demonstrating technical aspects of data acquisition, intravenous administration
of contrast agent and the modes of intestine preparation. The study encompasses 70 patients
(21men, 49 women). All the examinations were performed on computing tomograph with 16 parallel
series of detectors by means of collimation 16 x 0.75mmafter the administration of 80 ml of nonionic
contrast agent into the vein. After the intravenous administration of the contrast agent the method
of two phases in one injection was used. The scanning began with the time-lapse of 30 to 35 sec since
the administration of the contrast agent in order to saturate well the whole mesenterial vascular
bed, both arterial and venous. The examination of 22 patients was performed by the contrast agent
without preparing themorally, and most of the planned examinations (32) were performed after the
administration of isodense irrigation via a duodenal probe, whereas only 16 patients were examined
after oral preparation with a hyperdense contrast agent. The evaluation of 3 cases of acute enteritis,
3 cases of intestinal inflammation in immunodeficiency, 48 cases of Crohn disease, 9 cases of ulcerous
colitis, 3 cases of acute diverticulitis and 4 cases of induced colitis made it possible to evaluate
diagnostic importance of pathological changes in the intestinal wall. The evaluation of the type of
vascularization of intestinal wall plays a significant role in the differential diagnostics of intestinal
inflammations. A marked saturation of submucous or mucous layer with the contrast agent during
early portal phase after the injection is the most important sign of the process activity in intestinal
inflammations.
Key words:
computed tomography -multidetector computed tomography - intestinal inflammations
- Crohn disease - colitis
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