CT of Prominent Pericolic or Perienteric Vasculature in Patients with  Crohn's Disease: Correlation with Clinical Disease Activity and Findings on  Barium Studies

Lee, Seung Soo; Ha, Hyun Kwon; Yang, Suk Kyun; Kim, Ah Young; Kim, Tae Kyoung; Kim, Pyo Nyun; Lee, Moon Gyu; Myung, Seung Jae; Jung, Hwoon Yong; Kim, Jin Ho; Min, Young Il

doi:10.2214/ajr.179.4.1791029

Cited by 112 publications

(47 citation statements)

References 29 publications

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“…Few data exist about the relationship between signs of perienteric inflammation, such as those explored in our study, with clinical or biochemical indices of activity. Lee et al [37] first described the association of prominent perienteric or pericolic vasculature and active CD. Colombel et al [4] found a significant relationship between radiological findings of perienteric inflammation expressed by increased fat density and CRP.…”

Section: Discussionmentioning

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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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%

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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“…Symmetric hyperenhancement with minimal wall thickening is non-specific, particularly about a surgically created anastomosis. Finally, the ''comb sign'' refers to engorgement of the vasa recta and is highly suggestive of active inflammation [35] (Fig. 2).…”

Section: Mre Findings Used For Diagnosing Crohn's Diseasementioning

confidence: 99%

MR enterography in Crohn’s disease: current consensus on optimal imaging technique and future advances from the SAR Crohn’s disease-focused panel

2015

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“…Gray-scale US may reveal mesenteric thickening with areas of heterogeneous echogenicity due to edema, while color or power Doppler US may show increased mesenteric blood flow, including the "comb" sign due to vasa recta engorgement (Figs 10, 11). A CT study by Lee et al (23) showed that prominent perienteric vasculature is associated with active disease and that this finding is associated with the need for more aggressive medical management. Again, the sensitivity of Doppler US for detection of mesenteric hyperemia can be maximized by minimizing the pulse repetition frequency.…”

Section: Mesenteric Findings Inflammationmentioning

confidence: 99%

Pediatric Small Bowel Crohn Disease: Correlation of US and MR Enterography

Dillman¹,

Smith

Sanchez³

et al. 2015

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Small bowel Crohn disease is commonly diagnosed during the pediatric period, and recent investigations show that its incidence is increasing in this age group. Diagnosis and follow-up of this condition are commonly based on a combination of patient history and physical examination, disease activity surveys, laboratory assessment, and endoscopy with biopsy, but imaging also plays a central role. Ultrasonography (US) is an underutilized well-tolerated imaging modality for screening and follow-up of small bowel Crohn disease in children and adolescents. US has numerous advantages over computed tomographic (CT) enterography and magnetic resonance (MR) enterography, including low cost and no required use of oral or intravenous contrast material. US also has the potential to provide images with higher spatial resolution than those obtained at CT enterography and MR enterography, allows faster examination than does MR enterography, does not involve ionizing radiation, and does not require sedation or general anesthesia. US accurately depicts small bowel and mesenteric changes related to pediatric Crohn disease, and US findings show a high correlation with MR imaging findings in this patient population.

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CT of Prominent Pericolic or Perienteric Vasculature in Patients with Crohn's Disease: Correlation with Clinical Disease Activity and Findings on Barium Studies

Abstract: Prominent pericolic or perienteric vasculature seen on CT in patients with Crohn's disease suggests that the disease is clinically active, advanced, and extensive and that these patients require more aggressive treatment than patients without this CT finding.

Cited by 112 publications

References 29 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

MR enterography in Crohn’s disease: current consensus on optimal imaging technique and future advances from the SAR Crohn’s disease-focused panel

Pediatric Small Bowel Crohn Disease: Correlation of US and MR Enterography

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