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CT Enterography

Last Updated: 2026-01-01 Author:

  • 1. Clinical Summary

    Series Phase Coverage
    Delayed Arterial Contrast (45 sec delay) Diaphragm to Pubic symphysis
    Renal Delay 300 sec 1-2cm above and below kidneys
    • Crohn disease
    • Small bowel obstruction
    • Obscure GI bleeding
    • Small bowel mass

  • 2. Patient Prep

    • Position: Supine with arms raised
    • NPO Status: NPO 4 hours solids
    • Pre-Medication:
      • Neutral oral contrast (VoLumen): 1st bottle (450mL) at 90 min. 2nd bottle (450mL) at 60 min. Half bottle (225mL) at 30 min. Other half (225mL) at 5 min before scan

  • 3. IV Contrast & Injection

    Parameter Value
    Agent Isovue 370
    Volume 1.5 mL/kg
    Flow Rate 4-5 mL/s
    Duration 25s
    Timing Method Empiric Delay (45s)

    Use full dose if GFR > 30

    If GFR < 30

    Max Contrast = \(2*\left[\frac{\text{Patient Weight}}{75 \text{ kg}} * \text{eGFR}\right]\)

  • 4. Special Notes

    • Enterographic phase (45 sec). High volume neutral oral for bowel distension. 25 second injection. Scan 45 sec from start
    • Additional Recons: Curved MPR of bowel segments. Mesenteric vascular assessment
    • 18-20G IV. Ensure adequate oral contrast intake (total ~1350mL). May need anti-peristaltic agent

    Safety First

    • Renal Function: Verify eGFR > 30
    • Allergy: Check allergy history. Coordinate oral contrast timing
    • Assess bowel wall enhancement and thickness. Look for strictures fistulas abscesses. Mesenteric vascularity
    • Adequate oral contrast distension critical. High injection rate
Series Name Start Location End Location Delay Slice Thickness Notes
Scout Diaphragm Pubic symphysis N/A N/A AP
Enteric Phase Diaphragm Pubic symphysis 45 sec 0.625 mm Optimal small bowel enhancement
Renal Delay 1-2cm above kidneys 1-2cm below kidneys 300 sec 0.625 mm Renal Delay series
Plane Acquisition FOV Thickness/Increment Kernel IR Strength Notes
Axial Enteric Full AP 2.5 mm/2.5 mm Standard 3 Primary diagnostic
Coronal Enteric Full AP 3 mm/3 mm Standard 3 Bowel loop assessment
Sagittal Enteric Full AP 3 mm/3 mm Standard 3 Mesenteric evaluation
MIP Enteric Mesenteric vessels 5 mm slab Vascular 3 Vascular assessment