Computed tomography in the evaluation of Crohn disease

Goldberg, Henry I.; Gore, Richard M.; Margulis, Alexander R.; Moss, AA; Baker, EL

doi:10.2214/ajr.140.2.277

Cited by 156 publications

(57 citation statements)

References 5 publications

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“…In referral centres, CTE has outnumbered barium examinations to assist in Crohn's disease diagnosis [23,27]. CTE has been reported to influence disease management in 28 % of cases, mainly due to detection of complications and assessment of disease activity [27].…”

Section: Discussionmentioning

confidence: 99%

“…Mesenteric alterations included fibro-fatty proliferation (known as ''creeping fat'' of the mesentery), increased fat density, hypervascularity (consisting of the presence of the ''comb sign'') and lymph nodes. Fibro-fatty proliferation refers to [23]. Increased fat density refers to fluid density in the fat surrounding thickened or abnormally enhancing bowel, resulting from inflammatory infiltration of the perienteric adipose tissue.…”

Section: Visual Image Evaluationmentioning

confidence: 99%

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CT enterography as a powerful tool for the evaluation of inflammatory activity in Crohn’s disease: relationship of CT findings with CDAI and acute-phase reactants

Cappello

Tudisca

et al. 2014

Radiol med

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Purpose Few studies have correlated computed tomography enterography (CTE) findings with Crohn's disease (CD) clinical and biochemical activity. The aim of this study was to evaluate correlations between CTE findings with CD activity. Materials and methods The CTE datasets from 62 patients were retrospectively reviewed for different parameters: bowel wall thickening and hyperenhancement, mesenteric alterations, abdominal free fluid and complications related to the disease (fistulas, strictures, abscesses). Activity was assessed using the Crohn's Disease Activity Index (CDAI) and some biochemical markers (Creactive protein, erythrocyte sedimentation rate, alpha 2-globulins, fibrinogen, platelets, haemoglobin). Correlations between CTE parameters, clinical activity score and laboratory parameters were assessed by logistic regression. Results CDAI was significantly correlated with increased fat density (p = 0.03) and intestinal strictures (p = 0.04). Platelet counts were elevated in patients with enlarged mesenteric lymph nodes (p = 0.009) and the comb sign (p = 0.05). Serum alpha 2-globulins were higher in the presence of the comb sign (p = 0.03). Conclusion The CTE finding of perienteric inflammation (increased fat density) and vascular engorgement of the vasa recta in CD patients suggest that the disease is clinically active and that these patients may require more aggressive treatment than patients without these findings.

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Section: Discussionmentioning

confidence: 99%

Section: Visual Image Evaluationmentioning

confidence: 99%

CT enterography as a powerful tool for the evaluation of inflammatory activity in Crohn’s disease: relationship of CT findings with CDAI and acute-phase reactants

Cappello

Tudisca

et al. 2014

Radiol med

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“…Computed tomography is the most useful diagnostic imaging tool in such cases [16] . It has proved to be superior to barium studies in demonstrating the mural, serosal and mesenteric extent of disease [17][18][19] . The management is surgical with resection of the diseased segment advocated followed by primary jejuno-jejunal or jejuno-ileal anastomoses.…”

Section: Discussionmentioning

confidence: 99%

Jejunal diverticulosis is not always a silent spectator: A report of 4 cases and review of the literature

Patel¹,

Jefferis²,

Spiegelberg³

et al. 2008

WJG

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Jejunal diverticulosis (JD) is a rare clinical entity. The potential complications of this condition are discussed here through a series of cases presented to our centre. A retrospective analysis of four cases, which were diagnosed and treated, was performed. These included two cases of gastrointestinal haemorrhage, one case of perforation and one case of enterolith obstruction. All of these cases were secondary to jejunal diverticulosis and treated surgically. This was accompanied by a literature search to identify the different modalities for diagnosis and treatment of this condition. JD is rare and may lead to a diagnostic delay. Awareness of the wide spectrum of potential complications can prevent this delay.

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“…The latter can be done with computed tomography as well [26], How ever, US seems to be equally effective [27] and is much easier to use.…”

Section: Discussionmentioning

confidence: 99%

Detection of Extraintestinal and Intestinal Abnormalities in Inflammatory Bowel Disease by Ultrasound

Schölmerich¹,

Braun²,

Volk³

et al. 1987

Dig Surg

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Abdominal ultrasound (US) can detect extraintestinal and intestinal manifestations and complications of Crohn’s disease. However, the clinical value of routine examination of all patients with inflammatory bowel disease is not known. A total of 100 patients (70% outpatients) with inflammatory bowel disease – 74 Crohn’s disease (CD) and 26 ulcerative colitis (UC) – was studied by US without knowledge of clinical or laboratory data except the diagnosis of inflammatory bowel disease. 39% of the patients with CD showed intestinal abnormalities (target sign: 18%, bowel conglomerates 5%, bowel wall diameter > 5 mm: 20%, prestenotic dilatation: 1%), while 35% of patients with UC had such abnormalities (19% target sign and 27% increased bowel wall diameter). Gallstones were found in 12% of patients with CD and 4% of those with UC. Cholecystectomy had been performed in 7 and 4%, respectively. Renal stones were found in 4 and 8%, liver abnormalities in 19% of both patient groups. Overall, in 30 and 27% at least one extraintestinal abnormality was seen. No clear correlation of disease activity with the occurrence of intestinal or extraintestinal findings was found in CD while bowel abnormalities were more likely to be detected in patients with active UC. None of the laboratory parameters assessed predicted the finding of gallstones, renal stones or liver abnormalities. Renal stones occurred more often in patients with ileal resection and longer duration of disease. US was found to be useful in the routine investigation of patients with inflammatory bowel disease since it detects a considerable number of extraintestinal complications. In addition, it can demonstrate intestinal abnormalities and complications and might be an additional noninvasive method to assess disease activity in UC.

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Computed tomography in the evaluation of Crohn disease

Cited by 156 publications

References 5 publications

CT enterography as a powerful tool for the evaluation of inflammatory activity in Crohn’s disease: relationship of CT findings with CDAI and acute-phase reactants

CT enterography as a powerful tool for the evaluation of inflammatory activity in Crohn’s disease: relationship of CT findings with CDAI and acute-phase reactants

Jejunal diverticulosis is not always a silent spectator: A report of 4 cases and review of the literature

Detection of Extraintestinal and Intestinal Abnormalities in Inflammatory Bowel Disease by Ultrasound

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