Sebastian Tobias Schindera MD, Presenter: Nothing to Disclose

Rendon Clive Nelson MD, Abstract Co-Author: Consultant, General Electric Healthcare, Inc Research support, Bracco Diagnostics, Inc Research support, E-Z-EM, Inc Research support, Valleylab, Inc

David Delong, Abstract Co-Author: Nothing to Disclose

Tracy Anne Jaffe MD, Abstract Co-Author: Nothing to Disclose

Elmar Max Merkle MD, Abstract Co-Author: Speakers Bureau, Siemens AG Speakers Bureau, General Electric Company Consultant, Schering AG (Berlex Inc) Consultant, Bracco Group Research support, Schering AG (Berlex Inc) Research support, Bracco Group Research support, GlaxoSmithKline plc Research support, Pfizer Inc Stockholder, Siemens AG Stockholder, General Electric Company

Erik Karl Paulson MD, Abstract Co-Author: Speakers Bureau, General Electric Company

John Thomas MBBS, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

To determine quantitatively and qualitatively the timing for maximal enhancement of the normal small-bowel wall by using contrast-material-enhanced multidetector computed tomography (MDCT).

A single-level dynamic 16-slice MDCT scan (LightSpeed 16, GE Healthcare) was performed on 25 subjects (19 men, 6 women; age range: 23-82 years) without a history of small-bowel disease. For bowel preparation, subjects ingested 1350 mL 0.1% barium sulfate (VoLumen, E-Z-EM). Thirty seconds after the intravenous administration of 150 mL contrast material (Isovue 370, Bracco Diagnostics) at 5mL/sec, subjects received a serial dynamic acquisition, 10 images separated by 5-second intervals. Enhancement measurements over time were obtained from the small-bowel wall and the aorta yielding time-enhancement curves, time-to-peak enhancement and time intervals for 95% peak enhancement (95% Int). Three independent readers performed the qualitative assessment regarding small-bowel conspicuity. Quantitative and qualitative data were analyzed during the arterial phase, the enteric phase, representing peak small-bowel mural enhancement, and the venous phase. Paired Student’s t-test and Wilcoxon signed rank test were performed for verification of statistically significant differences (p < .05).

Time-to-peak enhancement for the small-bowel wall was 49.3±7.7 seconds , and on average 13.5±7.6 seconds after peak aortic enhancement. The average 95% Int for the small bowel spanned 45.1-54.6 seconds, and for the aorta, 35.8-40.2 seconds. Highest enhancement values were found during the enteric phase (p < .05). Regarding small-bowel conspicuity, images during the enteric phase were most preferred qualitatively with a significant difference between the enteric and arterial phases (p < .001) but not between the enteric and venous phases (P = .06).

On MDCT, peak mural enhancement of the normal small bowel occurs on average about 50 seconds after intravenous administration of contrast material or 14 seconds after peak aortic enhancement.

Imaging during peak mural enhancement of the small bowel may translate into improved detection and characterization of small-bowel disorders.

Schindera, S, Nelson, R, Delong, D, Jaffe, T, Merkle, E, Paulson, E, Thomas, J, et al, , Enhancement Pattern of the Small Bowel on Multidetector CT: When is the Optimal Temporal Window for Imaging?.  Radiological Society of North America 2006 Scientific Assembly and Annual Meeting, November 26 - December 1, 2006 ,Chicago IL. http://archive.rsna.org/2006/4438860.html