الفهرس 
Anatomy of bowel loopsOnly 14 pages are availabe for public view
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Abstract
IBD includes a group of life-long disorders with a relapsing and remitting course, whose precise etiology is unknown, including ulcerative colitis (UC) and Crohn’s disease (CD). UC affects the colon, with disease spreading in a contiguous manner from the rectum proximally. Conversely, CD can affect any part of the gastrointestinal tract, from the mouth to the anus .
This study was obtained to assess role of MSCT, using both negative oral contrast media and intravenous contrast iodinated in evaluation of IBD. Thirty patients presenting with already known or suspected chronic IBD were examined by MSCTE and the results were compared to the results of GIT endoscopies and histopathology as well as other laboratory data in all patients. We found that 24 cases had Crohn’s disease (18 with active disease, 6 with inactivity) and 6 patients had ulcerative colitis ( 4 with activity , 2 inactive cases).
With the improved resolution of MDCT, CTE remains the work-horse imaging modality for evaluation of IBD and its complications . CTE can visualize not only the bowel lumen, but also the bowel wall, visceral fat, intra-abdominal lymph nodes, mesenteric vasculature supplying the bowel and provides a global overview of the abdomen. Extra intestinal disease manifestations such as nephrolithiasis, sacroiliitis, can readily be evaluated .
CTE is noninvasive, less painful with high patient acceptance, which make it preferable than CT-E. It is easily and rapidly performed examination that offers important and relevant information in the diagnosis and management of patients with proven or suspected IBD. In addition, CT scanners are present in most emergency rooms, rendering it an ideal choice in the urgent or emergent setting . CT is an appropriate imaging examination for the diagnosis of IBD, the evaluation of response to intervention including post-surgical changes, and the detection of urgent and emergent complications such as abscess formation and acute bowel obstruction. An optimal technique with adequate bowel distention, by using mannitol, is required for obtaining accurate diagnostic results. A single (enteric) phase technique is used for bowel evaluation.
CTE is rated as the most appropriate imaging modality for evaluating known Crohn’s disease in patients with an acute exacerbation or suspected complications. Each of CTE findings for the IBDs is helpful for differential diagnosis.
Although capsule endoscopy provides better mucosal visualization, it does not allow visualization of abnormalities outside the bowel lumen. Moreover, it cannot be performed when the presence of a stricture is suspected.
The main disadvantage of this technique is the requisite radiation exposure of patients, particularly in young patients. However, recent development of advanced CT techniques is promising for radiation dose reduction without compromising diagnostic image quality. This disadvantage has affected its use and has helped MR enterography become a strong alternative method of evaluating IBD, especially those who are young and may require repeated examinations.
In conclusion, MSCTE with negative oral contrast medium in addition to intravenous iodinated contrast injection is a safe and well tolerated technique that is easily done and is sensitive to early intestinal wall changes. This technique is complementary to other imaging methods, endoscopy and laboratory studies for full assessment of the inflammatory bowel diseases, hence, it is useful in follow up and preoperative guidance.