Stuart Charles Morrison MD, Presenter: Nothing to Disclose

Sunny Chung Pitt MD, Abstract Co-Author: Nothing to Disclose

Robert Wyllie MD, Abstract Co-Author: Nothing to Disclose

Janet Russell Reid MD, Abstract Co-Author: Nothing to Disclose

To review our experience with CT Enterography in children using the oral contrast agent of barium sulphate and sorbitol [Volumen; E-Z-EM, NY-USA] to opacify the gastrointestinal tract. Multidetector CT scanning was performed with axial and coronal reconstruction to image the entire gastrointestinal tract.

A total of 20 pediatric patients with a mean age of 15.1 years [range 6 years to 25 years] were reviewed. The most common indication for the study was inflammatory bowel disease [55%] imaged for complications or diagnosis. Chronic abdominal pain was the indication in 40% and failed endoscopy in 5%. Volumen was administered orally after a 4 hour fast. Volumen was administered in three equal volumes over 20 minutes. CT scan was then performed 1 hour after the last dose. The total Volumen dose was 15ccs/Kg with a maximum total volume of 1350 ccs. Radiation dose was minimized with low mAs settings following the guidelines published by Donnelly L. et al AJR 2001;176:303-303.

Satisfactory visualization of the entire gastrointestinal tract was obtained in all cases providing diagnostic studies. Volumen was well tolerated by this older pediatric population without any complications. The studies were all felt to be technically diagnostic. CT enterography provided information of the small bowel and visualization of the entire colon not possible with other imaging modalities. CT enterography was also performed following failed endoscopy and unlike endoscopy does not require sedation. Endoscopy identified mucosal ulcers not visible on CT enterography and also uniquely provides biopsy material with histology.

CT Enterography is well tolerated in Pediatric patients and provides diagnostic visualization of the entire gastrointestinal tract with the added advantage of imaging the entire abdomen. Radiation dose was comparable to or less than the conventional upper gastrointestinal series and small bowel follow through with fluoroscopy.

CT Enterography can replace the traditional small bowel examination providing more information with potentially less radiation.

Morrison, S, Pitt, S, Wyllie, R, Reid, J, CT Enterography in Children.  Radiological Society of North America 2006 Scientific Assembly and Annual Meeting, November 26 - December 1, 2006 ,Chicago IL. http://archive.rsna.org/2006/4428385.html