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Radiology of the gastrointestinal tract 

Radiology of the gastrointestinal tract

Radiology of the gastrointestinal tract

A.H. Freeman

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date: 23 April 2017

The widespread introduction of endoscopic techniques has lessened the need for radiological examination of the intestinal tract, and has almost completely replaced it in the examination of the stomach. There remains, however, a major radiological role in the investigation of the small and large bowel; and clinically useful information can be obtained from thoughtful use of radiology in the diagnosis of abdominal and gastrointestinal disease in those regions of the world where facilities for endoscopy are not available.

The small intestine may be examined by a number of radiological means, including plain films, barium contrast studies, ultrasonography, CT, MRI, and nuclear medicine. Barium studies (follow-through or small-bowel enema) can provide good morphological detail of the mucosal surface of the bowel; cross-sectional imaging (usually CT or MRI) is required for disease in the wall of the bowel or outside it. CT is increasingly used as the primary investigation in suspected bowel obstruction. Nuclear medicine studies have two major roles in the examination of the small bowel: imaging with labelled white blood cells for the demonstration of inflammatory conditions, and with labelled red blood cells for the demonstration of potential bleeding sources.

Colonoscopy has revolutionized imaging approaches to the colon because of its therapeutic as well as diagnostic role, but it is not without risk and barium enema examination remains a much used alternative. CT is an increasingly used technique, particularly since the advent of multidetector CT (MDCT) allows three-dimensional reconstruction and thus so-called virtual colonoscopy.

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