CT Evaluation of Small Bowel Wall Lesions

Abstract

Introduction: MDCT has lead to vast improvement in depiction and characterisation of small bowel wall lesions especially differentiation of benign and malignant lesions. Aim: To evaluate the role of MDCT in suspected small bowel lesions in patients referred to Radiology Department of a Tertiary Care Centre at Aurangabad district of Maharashtra in India. Materials and Methods: Present observational study was done on 49 patients of suspected small bowel lesions referred for MDCT during November 2014-2016. Patients presenting with symptoms related to altered bowel habits, positive small bowel wall findings on plain CT, small bowel lesions detected on ultrasound, history of trauma undergoing CT-scan with small bowel wall thickening on USG/CT were included. Patients were followed up to therapeutic/biopsy/ operative diagnosis. Histopathological reports helped in retrospective confirmation of provisional diagnosis on MDCT. Results: Duodenum was most common location for malignant lesions. Ileum (43.5%) was the most common location for benign lesions. The malignant lesions showed heterogeneous mixed attenuation (100%), marked thickening (66.7%) and asymmetric thickening (100%). Benign lesions showed homogenous attenuation (89.1%), mild thickening (93.5%) and symmetrical thickening (97.8%). Focal thickening was seen in most of the malignant lesions (66.7%) while segmental involvement was seen in most of benign lesions (93.5%). All malignant lesions were associated with adjacent fat stranding. Amongst benign lesions, surrounding fat stranding was absent in 71.7% cases. Conclusion: MDCT imaging findings can provide very useful help in diagnosis of small bowel lesions along with clinical correlation especially for identification of benign or malignant nature of small bowel lesions.

Keywords

• attenuation
• neoplasm
• small bowel wall thickening