Multidetector Computed Tomography in Bowel Lesion Evaluation: Clinical Applications, Advantages, and Future Directions

Multidetector computed tomography (MDCT) has emerged as a pivotal imaging modality for evaluating bowel lesions, offering rapid image acquisition, high spatial resolution, and multiplanar reconstructions. It plays a critical role in diagnosing a wide spectrum of gastrointestinal pathologies, ranging from inflammatory bowel disease to neoplasms and bowel obstruction. This narrative review aims to explore the evolving role of MDCT in gastrointestinal imaging, highlighting its technical foundations, clinical utility, diagnostic performance, and integration with emerging technologies. A comprehensive literature search was conducted using databases such as PubMed, Scopus, and Google Scholar, focusing on articles published between 2000 and 2025. Priority was given to recent studies (2020–2025) and those emphasizing comparative effectiveness, artificial intelligence (AI) integration, and dual-energy computed tomography (DECT) applications in bowel imaging. MDCT provides detailed anatomical and functional insights that enhance the diagnostic accuracy of bowel lesions. It allows effective assessment of mural thickening, vascularity, and complications across conditions such as Crohn’s disease, colorectal carcinoma, ischemic colitis, and small bowel obstruction. Comparative studies show that MDCT outperforms conventional radiography and ultrasound in sensitivity and specificity for detecting bowel pathology. Innovations such as DECT, perfusion imaging, and AI-based algorithms further refine image interpretation and workflow efficiency. MDCT represents a cornerstone in gastrointestinal diagnostics by bridging advanced imaging capabilities with clinical requirements. Its expanding role, particularly with AI integration and dual-energy technology, signals a transformative shift in the evaluation of bowel lesions. Increasing accessibility to MDCT in resource-constrained settings and continued technological innovation are essential for optimizing global gastrointestinal care.