DIAGNOSTIC ACCURACY OF CT ENTEROGRAPHY IN THE DIAGNOSIS OF SMALL BOWEL DISEASES KEEPING HISTOPATHOLOGY AS GOLD STANDARD
DOI:
https://doi.org/10.18623/rvd.v23.5982Keywords:
Computed Tomography Enterography, Intestinal Tuberculosis, Small Intestine Diseases, Diagnostic Accuracy, Histopathology, Pediatric PopulationAbstract
Background: Small bowel tuberculosis (SBTB) remains a significant diagnostic challenge in tuberculosis-endemic regions due to overlapping clinical and radiological features with other small bowel diseases. Computed tomography enterography (CTE) offers a noninvasive modality for comprehensive bowel assessment, but its diagnostic accuracy requires validation against histopathology in pediatric populations. Objective: To determine the diagnostic accuracy of CT enterography in detecting small bowel tuberculosis, using histopathology as the gold standard in a pediatric population. Methods: This descriptive case series was conducted at the Department of Diagnostic Radiology, The Children’s Hospital and Institute of Child Health, Lahore, from December 2025 to March 2026. A total of 116 children aged 5–16 years with clinical suspicion of small bowel tuberculosis were included. All participants underwent standardized CTE followed by histopathological confirmation via ileocolonoscopy-guided biopsy. Diagnostic parameters including sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy were calculated using SPSS version 25. Stratification analysis was performed to assess the effect of demographic and clinical variables. Results: The mean age of participants was 10.8 ± 3.1 years, with a male predominance (58.6%). Histopathology confirmed small bowel tuberculosis in 26.7% of cases. CT enterography demonstrated a sensitivity of 87.1%, specificity of 92.9%, PPV of 81.8%, NPV of 95.2%, and overall diagnostic accuracy of 91.4%. Necrotic lymph nodes and bowel wall thickening were the most frequent imaging findings. Diagnostic performance remained consistent across age groups, gender, BMI categories, and duration of symptoms, with no statistically significant differences observed on stratification. Conclusion: CT enterography demonstrates high diagnostic accuracy for detecting small bowel tuberculosis in children and may serve as a reliable, noninvasive first-line imaging modality in resource-limited and tuberculosis-endemic settings.
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