Multi‑slice spiral CT evaluation of chronic radiation colitis and rectitis

Abstract

The aim of the present study was to retrospectively analyse the multi-slice spiral CT (MSCT) findings of radiation colitis and rectitis (RC&R). A total of 23 cases of RC&R detected by helical CT were included. The CT findings and clinical and endoscopy data of the patients were reviewed. The primary tumours included cancers of the cervix (n=17), rectum (n=4), ovaries (n=1) and bladder (n=1). The total dose of radiation per patient was 46-60 Gy (mean, 49.7 Gy) delivered over 5 weeks. The CT manifestations included different degrees of increased thickness of the intestinal wall (n=20, 87.0%), with a maximum thickness of 16.6 mm. On enhanced CT, the target sign was observed (n=16, 69.9%), with an obviously enhanced mucosa and/or serosa and the following changes observed: Oedema and increased density of the mesentery (n=15, 65.2%); increased density of the subcutaneous fat, and blurred and oedematous pelvic wall muscles (n=4, 17.4%), with the obturator internus and levator ani muscles being most commonly affected; narrowed intestinal lumen (n=3, 13.0%); and a small amount of ascitic fluid (n=2, 8.7%) located in the paracolic sulci and bladder or Douglas pouch. The 23 patients underwent colonoscopy and were diagnosed with RC&R. The major manifestations included telangiectasia and mucosal hyperaemia (n=21, 91.3%). MSCT of chronic RC&R (CRC&R) was associated with certain characteristic findings, which, combined with a medical history of radiotherapy and the clinical manifestations, may prove to be of value in the diagnosis of CRC&R.

A radiomics nomogram based on MSCT and clinical factors can stratify fibrosis in inflammatory bowel disease

“…MSCT can also evaluate vascular supply and vasodilation of the intestines, which are important factors in the development of fibrosis. In MSCT examinations, findings such as increased bowel wall thickness, luminal stenosis, and mural stratification are indicative of fibrosis 33,34 . Moreover, the presence of engorged vasa recta and pericentric fat stranding may suggest the severity of fibrosis 35 .…”

Impact of a Structured Report Template on the Quality of Multislice Spiral Computed Tomography Scan Reports for Small Bowel Diseases: A Preliminary Study

“…Also, for case selection, the disease types for the two methods (FTRs and SRs) were basically similar. Also, we included patients who had no surgical indications (e.g., mesenteric vascular disease, non-strangulated intestinal obstruction, and inflammatory bowel disease), and surgical pathology as the gold standard was not performed for these patients, although previous studies have demonstrated that clinical data, biochemical indicators, and imaging data can be used as diagnostic standards (28)(29)(30)(31); to ensure a more reliable accuracy evaluation, these patients should be excluded. Second, pretreatment preparation, scanning techniques, and individual differences between patients could partially influence the manifestations of SBDs, and perfect intestinal filling and excellent image quality were not guaranteed for all patients in this study.…”