Yoon Hea Park1, Woo-Suk Chung, Joon Seok Lim, Soo Jung Park, Jae Hee Cheon, Tae Il Kim, Won Ho Kim, Sung Pil Hong. 1. From the *Department of Internal Medicine and Institute of Gastroenterology, Yonsei University College of Medicine, Seoul; †Department of Diagnostic Radiology, Konyang University Hospital, Konyang University College of Medicine, Daejon; and ‡Department of Radiology, Yonsei University College of Medicine, Seoul, South Korea.
Abstract
OBJECTIVES: The aim of the present study was to evaluate the diagnostic role of computed tomographic enterography (CTE) in distinguishing Crohn disease (CD) from intestinal tuberculosis (ITB). MATERIALS AND METHODS: From January 2006 to August 2011, a total of 81 consecutive patients (64 patients with CD and 17 patients with ITB) who received CTE on the initial workup were included. In CTE, degree of bowel involvement (number and length), mural change (mural hyperenhancement, stratification, wall thickening, and distribution), adjacent mesenteric change (comb sign, fibrofatty proliferation, fistula, abscess, and lymphadenopathy), and peritoneal change (peritoneal thickening and ascites) were assessed. RESULTS: Segmental involvement, comb sign, fibrofatty changes, moderate wall thickening, and asymmetric distribution were significantly more common in the patients with CD than those with ITB. A positive comb sign was the most suggestive finding of CD (sensitivity, 74.1%; specificity, 90.9%). CONCLUSIONS: A positive comb sign is the most suggestive finding that differentiates CD from ITB.
OBJECTIVES: The aim of the present study was to evaluate the diagnostic role of computed tomographic enterography (CTE) in distinguishing Crohn disease (CD) from intestinal tuberculosis (ITB). MATERIALS AND METHODS: From January 2006 to August 2011, a total of 81 consecutive patients (64 patients with CD and 17 patients with ITB) who received CTE on the initial workup were included. In CTE, degree of bowel involvement (number and length), mural change (mural hyperenhancement, stratification, wall thickening, and distribution), adjacent mesenteric change (comb sign, fibrofatty proliferation, fistula, abscess, and lymphadenopathy), and peritoneal change (peritoneal thickening and ascites) were assessed. RESULTS: Segmental involvement, comb sign, fibrofatty changes, moderate wall thickening, and asymmetric distribution were significantly more common in the patients with CD than those with ITB. A positive comb sign was the most suggestive finding of CD (sensitivity, 74.1%; specificity, 90.9%). CONCLUSIONS: A positive comb sign is the most suggestive finding that differentiates CD from ITB.
Authors: Saurabh Kedia; Raju Sharma; Govind K Makharia; Vineet Ahuja; Devendra Desai; Devasenathipathy Kandasamy; Anu Eapen; Karthik Ganesan; Uday C Ghoshal; Naveen Kalra; D Karthikeyan; Kumble Seetharama Madhusudhan; Mathew Philip; Amarender Singh Puri; Sunil Puri; Saroj K Sinha; Rupa Banerjee; Shobna Bhatia; Naresh Bhat; Sunil Dadhich; G K Dhali; B D Goswami; S K Issar; V Jayanthi; S P Misra; Sandeep Nijhawan; Pankaj Puri; Avik Sarkar; S P Singh; Anshu Srivastava; Philip Abraham; B S Ramakrishna Journal: Indian J Gastroenterol Date: 2018-01-06