MULTIPLANAR HELICAL CT ENTEROGRAPHY IN PATIENTS WITH CROHNS-DISEASE

OBJECTIVE. The purpose of this study was to assess the feasibility and usefulness of helical CT with multiplanar reformations in revealing c omplications in patients with Crohn's disease. SUBJECTS AND METHODS. T wenty-two patients with Crohn's disease and clinically suspected compl ications underwent helical CT enterography. The imaging protocol began with the administration of a large volume (1600 mi) of oral contrast material followed by helical scanning with axial and multiplanar two-d imensional coronal projections, Three independent observers assessed t he adequacy of bowel opacification and the contribution of two-dimensi onal coronal projections to the interpretation of axial images, CT ent erography was compared with conventional barium studies in 14 patients , Statistical analysis included repeated measures analysis of variance , the Wilcoxon signed-rank test, and the McNemar test. RESULTS. The la rge oral contrast medium dose was well tolerated and provided optimal bowel opacification in 21 of 22 patients, The addition of multiplanar to conventional axial images did not reveal additional abnormalities; however, multiplanar imaging significantly improved observers' confide nce in their interpretation of imaging and in their assessment of the extent of bowel wall thickening (p <.01), Interobserver agreement was 78%. Findings on helical CT were comparable with those on barium studi es in nine of 14 patients, superior to those on barium studies in four patients, and inferior in one patient. CONCLUSION. CT enterography is a useful technique for bowel imaging. In patients with complicated Cr ohn's disease, multiplanar imaging improves confidence in assessing th e presence and extent of disease, CT enterography is complementary and often superior to conventional barium studies.