Abdominal Imaging

, Volume 37, Issue 1, pp 61–69

MDCT assessment of ulcerative colitis: radiologic analysis with clinical, endoscopic, and pathologic correlation

  • Bijal Patel
  • Jeffrey Mottola
  • V. Anik Sahni
  • Vito Cantisani
  • Mehmet Ertruk
  • Sonia Friedman
  • Andrew M. Bellizzi
  • Andrea Marcantonio
  • Koenraad J. Mortele
Article

DOI: 10.1007/s00261-011-9741-x

Cite this article as:
Patel, B., Mottola, J., Sahni, V.A. et al. Abdom Imaging (2012) 37: 61. doi:10.1007/s00261-011-9741-x

Abstract

Purpose

Evaluate the utility of multidetector-row computed tomography (MDCT) in assessing the severity of ulcerative colitis (UC) in comparison with clinical assessment, colonoscopy, and histopathology.

Materials and methods

Patients with UC evaluated with at least one abdominal contrast-enhanced CT study (CECT) within 7 days of colonoscopy with biopsy were included. CECT of 23 patients (12 male; mean age 40 years; age range, 20–72 years) were retrospectively evaluated in consensus by two radiologists. A total of 138 lower GI tract segments were evaluated by CECT and graded for the presence of bowel wall thickening, mucosal hyperenhancement, mural stratification, mesenteric hyperemia, pericolonic stranding, and lymph nodes. A cumulative CT severity score was calculated and correlated with clinical, colonoscopic, and histopathologic severity grades.

Results

The cumulative CT score and individual CECT scores for bowel wall thickening, mucosal hyperenhancement, and mural stratification showed positive correlation with clinical severity (P < 0.05). All individual CECT features as well as the cumulative CT score demonstrated statistically significant correlation with colonoscopic severity (P < 0.0001). Only wall thickening on CECT demonstrated significant correlation with histopathologic severity (P = 0.01).

Conclusion

Disease severity assessment by MDCT demonstrates positive correlation with severity established by clinical assessment and colonoscopy. Only increasing wall thickness, as graded on MDCT, correlates with histopathologic disease severity.

Keywords

Ulcerative colitisMultidetector-row CT (MDCT)ColonoscopyPathologic

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Bijal Patel
    • 1
  • Jeffrey Mottola
    • 1
  • V. Anik Sahni
    • 1
  • Vito Cantisani
    • 1
    • 3
  • Mehmet Ertruk
    • 4
  • Sonia Friedman
    • 2
  • Andrew M. Bellizzi
    • 5
  • Andrea Marcantonio
    • 1
    • 3
  • Koenraad J. Mortele
    • 1
  1. 1.Division of Abdominal Imaging & Intervention, Department of RadiologyBrigham and Women’s Hospital, Harvard Medical SchoolBostonUSA
  2. 2.Division of Gastroenterology, Department of MedicineBrigham and Women’s Hospital, Harvard Medical SchoolBostonUSA
  3. 3.Department of RadiologyLa Sapienza HospitalRomeItaly
  4. 4.Department of RadiologySisli Etfal Training and Research HospitalIstanbulTurkey
  5. 5.Department of PathologyBrigham and Women’s HospitalBostonUSA