The Effectiveness of CT Enterography in theRadiological Evaluation of Crohn’s Disease

Objective:The aim of this study is to evaluate the effectiveness of computed tomography enterography (CTE) in demonstrating luminal and extraluminal pathologies in patients diagnosed with Crohn’s disease (CD).Method:In 20 symptomatic patients histopathologically diagnosed with CD, CTE findings obtained after optimal bowel distension with oral contrast material were evaluated retrospectively. The involved segment was evaluated in terms of the presence of intestinal wall thickening (focal or diffuse), pathological contrast enhancement in the intestinal wall, increased vascularity in the intestinal mesentery, mesenteric lymphadenopathy, intraperitoneal fluid, enteric fistula, and intraabdominal abscess. In addition, evaluation was made in terms of extraintestinal findings that might be related to the disease.Results:A total of 20 patients (11 females, 9 males; age range: 24 to 61 years, mean age: 39.7±11.4 years) were included in the study. The most frequently affected intestinal segment was the terminal ileum (n=10, 50%). Pathological intestinal wall enhancement was detected in 14 patients (70%), mesenteric lymphadenopathy in 16 patients (80%), and comb sign in 15 patients (75%). Intraabdominal abscess was detected in 4 cases (20%) and enteric fistula in 4 cases (20%). Related to the disease, kidney stones in one patient and previous cholecystectomy findings in two patients were observed.Conclusion:CTE is a very effective method that can simultaneously monitor the intestinal and extraintestinal findings of the symptomatic patients with CD and guide the treatment choice

Computed Tomography-Guided Lumbar Puncture: Advantages and Disadvantages.

Objective This study aimed to evaluate the utility of computed tomography (CT) guidance in difficult lumbar puncture (LP) cases, which had a history of at least one unsuccessful blind attempt at LP (no imaging guidance), and to note potential advantages and disadvantages of the use of CT guidance. Methods In total, 32 CT-guided LP procedures performed between June 2019 and March 2021 were included. All LP indications were recorded. The procedures where the cerebrospinal fluid flow was provided by a single puncture were evaluated as "primary technical success." "Secondary technical success" corresponded with the procedures in which additional puncture was necessary for the cerebrospinal fluid flow. Results Intrathecal nusinersen injections due to spinal muscular atrophy constituted the largest procedure group of this study. Among 32 procedures, primary and secondary technical success rates were 78.12% and 28.57%, respectively. There were no major procedural complications. Conclusions Computed tomography-guided LP is an effective interventional technique offering an alternative approach in the setting of difficult LP procedures