Pilot study of endoscopic retrograde 3-dimensional – computed tomography enteroclysis for the assessment of Crohn’s disease

Abstract

Purpose: Endoscopic retrograde ileography (ERIG) is developed in our institute and applied clinically for the diagnosis and assessment of the Crohn’s disease activity. We have further improved the technique using 3-dimensional – 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 Crohn’s disease patients in a state of remission. Methods: Thirteen Crohn’s 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 Crohn’s 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 Crohn’s disease were visualized using ER 3D-CTE. A cobble stone appearance or hammock-like malformation was specific and effective for diagnosing Crohn’s 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 Crohn’s disease patients and may be used for the diagnosis and follow-up of this disease. Keywords: Crohn’s disease, Ileography, Computed tomography, 3-Dimension