Small intestinal tumors: diagnostic accuracy of enhanced multi-detector CT virtual endoscopy.

ABSTRACT

OBJECTIVE: To study the diagnostic accuracy of enhanced multi-detector CT virtual endoscopy (MDCT-VE) for small intestinal tumors. MATERIALS AND METHODS: 125 patients were examined by multi-detector CT (MDCT 54 on 4-slice; 71 on 64-slice) following standard gastrointestinal tract cleansing, oral double contrast aerogenesis agent, and rectal gas administration. Unenhanced CT was performed, followed by enhanced CT in supine (30 and 80s delay after 100 mL standard intravenous contrast medium) and prone positions (180s delay). Supplementary CT in the lateral position was performed if small bowel was not well-filled. Images were reviewed on post-processing workstations with Virtual Endoscopy software. RESULTS: 33/125 patients had proven small intestinal tumors ten stromal tumors, nine lymphoma, eight adenocarcinomas, three hemangiomas, one each lipoma, Brunner gland adenoma, and hamartoma. 92 were nontumors. MDCT-VE correctly identified 30/33 cases with one false-positive diagnosis sensitivity 90.9%, specificity 98.9% and accuracy 96.8%. CONCLUSION: Small intestinal MDCT-VE technique has high diagnostic accuracy for the detection of intestinal tumors. Contrast enhancement and adequate intestinal tract gas-filling can improve the detection rate for small intestinal tumors.