Abstract
Computed tomographic enterography (CTE) is a useful technique for evaluating the small bowel and has the capability to include the colon for evaluation of patients with inflammatory bowel disease (IBD). The aims of this study are (1) to determine if CTE is a sensitive method for detecting Crohn colitis and ulcerative colitis and (2) to assess the accuracy of determining the extent and activity of colonic disease in patients with proven IBD. Seventy patients (35 patients with proven colitis at colonoscopy and 35 negative patients with a proven normal colon) having both a CTE examination and recent colonoscopy formed the retrospective study group. A radiologist evaluated the examinations in a blinded fashion for disease presence, activity, and extent. Sensitivity was 93% for the detection of moderate and severe disease in well-distended colons. Specificity was 91%. In good to excellent distended colons, mild, moderate, and severe disease was detected with a sensitivity of 67%, 90%, and 100%, respectively. Severe disease activity was commonly underestimated, and mild disease when detected was usually overestimated. The full extent of colonic disease at CTE was usually underestimated. CTE is a valid technique for detecting colitis in the colon in patients with IBD. Better methods for assessing disease activity and extent are needed.
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References
Paulsen SR, Huprich JE, Hara AK (2007) CT enterography: noninvasive evaluation of Crohn’s disease and obscure gastrointestinal bleed. Radiol Clin North Am 45(2):303–315. doi:10.1016/j.rcl.2007.03.009
Ozturk E, Cakir O, Mutlu H, Sonmez G, Sildiroglu HO, Basekim CC, Kizilkaya E (2007) Diagnostic value of CTE in patients with Crohn’s disease. Clin Imaging 31(3):185–188. doi:10.1016/j.clinimag.2007.01.005
Paulsen SR, Huprich JE, Fletcher JG, Booya F, Young BM, Fidler JL, Johnson CD, Barlow JM, Earnest F (2006) CT Enterography as a diagnostic tool in evaluating small bowel disorders: review of clinical experience with over 700 cases. Radiographics 26:641–657. doi:10.1148/rg.263055162
Gore R, Blathazar E, Gjajreamo G, Miller F (1996) CT features of ulcerative colitis and Crohn’s disease. Am J Roentgenol 167:3–15
Horsthuis K, Stokkers P, Stoker J (2007) Detection of inflammatory bowel disease: diagnostic performance of cross-sectional imaging modalities. Abdom Imaging 33:407–416
Wold PB, Fletcher JG, Johnson CD, Sandborn WJ (2003) Assessment of small bowel Crohn disease: noninvansive peroral CT Enterography compared with other imaging methods and endoscopy—feasibility study. Radiology 229:275–281
Bodily K, Fletcher JG, Solem C, Johnson CD, Fidler JL, Barlow JM, Bruesewitz MR, McCollough CH, Sandborn WJ, Loftus EV, Harmsen WS, Crownhart BS (2006) Crohns disease: mural attenuation and thickness at contrast-enhanced CT Enterography—correlation with endoscopic and histologic findings of inflammation. Gastrointest Imaging Radiol 238:505–516. doi:10.1148/radiol.2382041159
Dubinsky MC, Seidman EG (2000) Diagnostic markers of inflammatory bowel disease. Curr Opin Gastroenterol 16(4):337–342. doi:10.1097/00001574-200007000-00008
Ajaj W, Goehde S, Schneemann H, Ruehm S, Debatin J, Lauenstein T (2003) Oral contrast agents for small bowel MRI: comparison of different additives to optimaize bowel distention. Eur Radiol 14:458–464
Thoeni RF, Cello JP (2006) CT imaging of colitis. Radiology 240(3):623–638 . doi:10.1148/radiol.2403050818
Zalis M, Singh AK (2004) Imaging of inflammatory bowel disease: CT and MR. Dig Dis 22(1):56–62. doi:10.1159/000078735
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Johnson, K.T., Hara, A.K. & Johnson, C.D. Evaluation of colitis: usefulness of CT enterography technique. Emerg Radiol 16, 277–282 (2009). https://doi.org/10.1007/s10140-008-0776-4
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DOI: https://doi.org/10.1007/s10140-008-0776-4