CT DIAGNOSTICS OF INTRALUMINAL AND INTRAMURAL FORMATIONS IN THE INTESTINE
Intestinal tumors is not a rare pathology. For example, colon cancer ranks the 4th place among all localizations. Endophytic or intramural colon cancer is an unfavorable sign, with a decrease in 5-year survival after radical treatment up to 41.2%. Diagnostics of intramural formations in the small intestine or in the colon is not easy, including traditional endoscopy. CT role in examining abdominal organs with intravenous contrast enhancement which is a routine and commonly used technique for examining parenchymal organs of the abdominal cavity is poorly presented in the diagnostics of intestinal diseases. Purpose. To determine potentials for CT diagnostics with bolus contrast enhancement (CE) in intraluminal (IL) formations and intramural (IM) intestinal formations. Materials and methods. Findings of 572 CT examinations of the abdomen with the standard protocol using multislice tomographs were analyzed; among them 206 cases had verified intestinal diseases and 366 cases had no intestinal pathology. Results. The wall thickness of the colon is normally < 5 mm, of small intestines < 4 mm, with an average density of 45.0 ± 34.8 HU and 45.2 ± 14.9 HU, respectively. The average post-contrast density of the colon wall is 70.8 HU, of the small intestine is 86.6 HU. IM and IL formations in 82% of cases were localized in the colon, in 18% - in the small intestine, intramural localization - in 49.5%. CT symptoms in the diagnostics of IL and IM intestinal formations with absolute risks: local wall thickness (10.9%), lumen dilatation (31.2%), regional lymphadenopathy (6.0%), wall ulceration (11.7%), local wall thickness and lumen narrowing (62.2%), pathological CE 82.2% with the highest gradient of CE IM formations in the small intestine up to 150 HU. Conclusion. Examination of the abdomen with CT CE is an effective modality for detecting and differentiating IL and IM intestinal formations with sensitivity of 92.3%, specificity of 77.4% and efficiency of 84.9%. As far as Il and IM intestinal formations are infrequently complicated with hemorrhages, abdominal standard CT may be considered as a method of choice in case of intestinal bleeding, unrecognized endoscopically, to exclude causal changes in the intestine.