Role of Multi-Detector Row CT in Evaluation of Inflammatory Bowel Disease
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- Category: Vol. 80, June 2012
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Role of Multi-Detector Row CT in Evaluation of Inflammatory Bowel Disease,SAID ABDEL MONEM, INAS M. EL FIKI, TALAAT FATHY and ASHRAF ESMAIEL
Abstract
Objective: The purpose of this study is to evaluate the role of multi-detector CT in diagnosis of inflammatory bowel diseases and its ability to narrow the differential diagnosis of their various etiological causes.
Patients and Methods: In the period between June 2010 and January 2012, multi-detector abdominal and pelvic CT images for thirty three patients were done (25 males and 8 females; mean age 35 years). The scanning was obtained after intra-venous contrast medium injection, and also delineation of the bowel lumen was obtained by diluted oral gastrographin. Images were evaluated for location of the lesion along the course of the bowel (which segment of the bowel is affected), the length of involved segment, the degree of thickening, whether the thickening is symmetric or asymmetric, the pattern of enhancement, and the presence of abnormalities in the mesentery, lymph nodes enlargements and presence of ascites.
Results: One patient with focal thickening of the transverse colon was proved to have cancer colon and was excluded from the study. Fifteen patients were proved to have Crohn's disease, 10 patients had ulcerative colitis, 2 patients had ischemic enteritis and 5 patients had ischemic colitis. The definitive diagnosis was provided by endoscopic evaluation and biopsy taking in 25 patients, surgical specimen and histopathological examination in 3 patient and conservative treatment with follow up in four patients.
Conclusion: Multi-detector row CT (MDCT) with its ability of accurate localization of the involved bowel segment, accurate determination of the extent and appearance of wall thickening and its ability in the evaluation of intramural disease as well as extra luminal extension of colonic diseases can help distinguish between Crohn’s disease and ulcerative colitis, and aid to narrow the differential diagnosis with other conditions; which may display similar clinical and laboratory findings as ischemia and neoplasm.