What is the role of CT enterography in the diagnosis of Crohn disease?

Updated: Jul 26, 2019
  • Author: Leyla J Ghazi, MD; Chief Editor: Praveen K Roy, MD, AGAF  more...
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Answer

CT enterography can be helpful in the assessment of subtle and obvious mucosal damage. VoLumen oral contrast (Bracco Diagnostics, Princeton, NJ) is used as a negative agent to enhance small bowel wall changes, if present. Active disease is demonstrated by bowel wall thickening and mural hyperenhancement that occurs in a stratified enhancement pattern and a hyperemic vasa recta. [65] In the presence of severe inflammation, perienteric inflammatory changes can be seen.

CT enterography is also useful in deciphering whether a stricture is fibrostenotic rather than inflammatory or mixed. The degree and length of narrowing are important in planning for endoscopic examination (eg, by determining whether dilation is possible) and in preoperative staging.


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