L Plastaras1, L Vuitton1, N Badet2, S Koch1, V Di Martino3, E Delabrousse4. 1. Department of Gastroenterology, University Hospital, 3 Boulevard Fleming, 25030 Besançon, France. 2. Department of Radiology, University Hospital, 3 Boulevard Fleming, 25030 Besançon, France. 3. Department of Hepatology, University Hospital, 3 Boulevard Fleming, 25030 Besançon, France. 4. Department of Radiology, University Hospital, 3 Boulevard Fleming, 25030 Besançon, France; EA 4662 Nanomedicine Lab, Imagery and Therapeutics, University of Franche-Comté, Besançon, France. Electronic address: edelabrousse@chu-besancon.fr.
Abstract
AIM: To investigate the utility of multidetector CT (MDCT) in helping to establish the underlying cause of acute colitis. METHODS AND MATERIALS: All patients who had acute colitis with a well-identified cause and underwent abdomen 64-MDCT were included in the study. MDCT images were retrospectively analysed in a blinded fashion and the CT findings were correlated with the eventual aetiological diagnosis. RESULTS: The study population included 105 patients. Acute colitis was related to inflammatory bowel disease in 43 cases. MDCT was used to identify six relevant signs of inflammatory colitis: the "comb" sign (p < 0.001), enlarged lymph nodes (p < 0.001), abscess (p = 0.026), fibro-fatty infiltration (p = 0.007), small bowel involvement (p < 0.001), and the absence of an "empty colon" sign (p = 0.045). Multivariate logistic regression analysis identified three independent signs of inflammatory colitis: the "comb" sign, small bowel involvement, and enlarged lymph nodes. Acute colitis was related to bacterial infection in 35 cases. Five signs were significantly associated with infectious colitis: continuous distribution (p = 0.020), an "empty colon" sign (p = 0.002), absence of fat stranding (p = 0.013), and absence of a "comb" sign (p = 0.010) and absence of enlarged lymph nodes (p = 0.035). Multivariate analysis identified three independent signs: the "empty colon" sign and absence of fat stranding and of a "comb" sign. The remaining causes were ischaemic colitis (n = 21) and drug-related colitis (n = 6). MDCT examination provided five relevant signs of ischaemic colitis: fat stranding (p = 0.002), discontinuous distribution (p < 0.001), and absence of enlarged lymph node (p < 0.001), a "comb" sign (p = 0.006) and small bowel involvement (p = 0.037). CONCLUSIONS: MDCT provides certain suggestive signs that may be helpful in distinguishing the underlying aetiological cause of acute colitis.
AIM: To investigate the utility of multidetector CT (MDCT) in helping to establish the underlying cause of acute colitis. METHODS AND MATERIALS: All patients who had acute colitis with a well-identified cause and underwent abdomen 64-MDCT were included in the study. MDCT images were retrospectively analysed in a blinded fashion and the CT findings were correlated with the eventual aetiological diagnosis. RESULTS: The study population included 105 patients. Acute colitis was related to inflammatory bowel disease in 43 cases. MDCT was used to identify six relevant signs of inflammatory colitis: the "comb" sign (p < 0.001), enlarged lymph nodes (p < 0.001), abscess (p = 0.026), fibro-fatty infiltration (p = 0.007), small bowel involvement (p < 0.001), and the absence of an "empty colon" sign (p = 0.045). Multivariate logistic regression analysis identified three independent signs of inflammatory colitis: the "comb" sign, small bowel involvement, and enlarged lymph nodes. Acute colitis was related to bacterial infection in 35 cases. Five signs were significantly associated with infectious colitis: continuous distribution (p = 0.020), an "empty colon" sign (p = 0.002), absence of fat stranding (p = 0.013), and absence of a "comb" sign (p = 0.010) and absence of enlarged lymph nodes (p = 0.035). Multivariate analysis identified three independent signs: the "empty colon" sign and absence of fat stranding and of a "comb" sign. The remaining causes were ischaemic colitis (n = 21) and drug-related colitis (n = 6). MDCT examination provided five relevant signs of ischaemic colitis: fat stranding (p = 0.002), discontinuous distribution (p < 0.001), and absence of enlarged lymph node (p < 0.001), a "comb" sign (p = 0.006) and small bowel involvement (p = 0.037). CONCLUSIONS: MDCT provides certain suggestive signs that may be helpful in distinguishing the underlying aetiological cause of acute colitis.
Authors: Francesca Iacobellis; Donatella Narese; Daniela Berritto; Antonio Brillantino; Marco Di Serafino; Susanna Guerrini; Roberta Grassi; Mariano Scaglione; Maria Antonietta Mazzei; Luigia Romano Journal: Diagnostics (Basel) Date: 2021-05-30