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Acute colitis: differential diagnosis using multidetector CT.

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.

journal_name

Clin Radiol

journal_title

Clinical radiology

authors

Plastaras L,Vuitton L,Badet N,Koch S,Di Martino V,Delabrousse E

doi

10.1016/j.crad.2014.11.008

subject

Has Abstract

pub_date

2015-03-01 00:00:00

pages

262-9

issue

eissn

0009-9260

issn

1365-229X

pii

S0009-9260(14)00504-2

journal_volume

pub_type

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Acute colitis: differential diagnosis using multidetector CT.