Pilot study of endoscopic retrograde 3-dimensional â computed tomography enteroclysis for the assessment of Crohnâs disease

• Main Authors: Hiroki Tanabe, Takahiro Ito, Yuhei Inaba, Katsuyoshi Ando, Yoshiki Nomura, Nobuhiro Ueno, Shin Kashima, Kentaro Moriichi, Mikihiro Fujiya, Toshikatsu Okumura
• Format: Article
• Language: English
• Published: Elsevier 2017-01-01
• Series: European Journal of Radiology Open
• Online Access: http://www.sciencedirect.com/science/article/pii/S2352047717300126

Purpose: Endoscopic retrograde ileography (ERIG) is developed in our institute and applied clinically for the diagnosis and assessment of the Crohnâs disease activity. We have further improved the technique using 3-dimensional â computed tomography enteroclysis (3D-CTE) and conducted a retrospective study to determine the feasibility and the diagnostic value of endoscopic retrograde 3D-CTE (ER 3D-CTE) in Crohnâs disease patients in a state of remission. Methods: Thirteen Crohnâs patients were included in this pilot study. CTE was performed after the infusion of air or CO2 through the balloon tube following conventional colonoscopy. The primary endpoint of this study was to assess the safety of this method. Secondarily, the specific findings of Crohnâs disease and length of the visualized small intestine were assessed. Results: The procedures were completed without any adverse events. Gas passed through the small intestine and enterographic images were obtained in 10 out of 13 cases, but, in the remaining patients, insertion of the balloon tubes into the terminal ileum failed. Various features specific to Crohnâs disease were visualized using ER 3D-CTE. A cobble stone appearance or hammock-like malformation was specific and effective for diagnosing Crohnâs disease and the features of anastomosis after the surgical operations were also well described. Therefore, this technique may be useful after surgery. Conclusion: In this study, ER 3D-CTE was performed safely in Crohnâs disease patients and may be used for the diagnosis and follow-up of this disease. Keywords: Crohnâs disease, Ileography, Computed tomography, 3-Dimension