Spiral CT Findings in Active and Remission Phases in Patients with Crohn Disease

Campo, L. Del; Arribas, Ignacio; Valbuena, Marta Ruiz de; Maté, J.; Moreno–Otero, Ricardo

doi:10.1097/00004728-200109000-00020

Cited by 63 publications

(27 citation statements)

References 14 publications

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“…Recently, a few papers have suggested the role of radiological techniques such as computed tomography enteroclysis or enterography (CTE) and magnetic resonance enteroclysis or enterography (MRE) not only in detecting extramural complications but also in the evaluation of disease activity [5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

“…The CTE finding of either enteric signs such as mural stratification and hyperenhancement or perienteric signs like mesenteric hypertrophy or engorged vasa recta, the socalled ''comb sign'', has been found to correlate either with endoscopic or histological inflammation or with acutephase proteins, with sometimes discrepant results [6,7,[10][11][12]. The importance of recognising the different patterns of disease, especially early in the disease course, may help in tailoring specific therapies, predicting future complications, and possibly offering better timing of surgical interventions [13].…”

Section: Introductionmentioning

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: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

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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“…The diagnosis of a small bowel target sign most commonly correlates with intussusception. Although CT target signs have also previously been described in patients with Crohn's Disease [2], chronic radiation enteritis and graft versus host disease [1], this is the first report of a small bowel target sign caused by an obstructing foreign body (phytobezoar) cast ejected from a Meckel's diverticulum.…”

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confidence: 70%

Computed Tomography Target Sign: A Case of Mistaken Intussusception

et al. 2010

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A 57-year-old male presented with a complete small bowel obstruction. Computed tomography confirmed an obvious transition point in the distal ileum, as well as an adjacent small bowel target sign. At exploratory laparotomy, the CT target sign had been caused by an obstructing phytobezoar cast ejected from a Meckel's diverticulum. Keywords Meckel's diverticulum . Target sign A previously healthy 57-year-old male presented with a complete small bowel obstruction. His vomiting was nonbilious in nature. Physical exam revealed significant abdominal tenderness and distention. Computed tomography (CT) confirmed a small bowel obstruction with an obvious transition point in the distal ileum. This finding was also associated with an adjacent small bowel target sign (Fig. 1). At exploratory laparotomy, a large phytobezoar was noted to be obstructing the ileocecal valve. It was consistent in size and shape with the intra-luminal dimensions of the meckel's diverticulum (Fig. 2). In spite of our suspected diagnosis, no intussusception was present. After reducing the phytobezoar back into the diverticulum, a small bowel resection with a functional end to end stapled anastamosis was performed.

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“…Ileo-cecal TB accounts for 90% of intestinal involvement [12,13]. The majority (80-85%) of patients haves no evidence of active or previous pulmonary TB on chest radiography [14].…”

Section: Infectious Diseasesmentioning

confidence: 99%

Diseases of the cecum: a CT pictorial review

et al. 2002

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Cecal pathology is commonly encountered and may represent a diagnostic challenge in patients with either acute or chronic clinical presentations. Although appendicitis accounts for the majority of surgical conditions presenting with right lower quadrant pain, readers should be aware of the broad spectrum of cecal pathologies and characteristic CT findings, which can be useful in establishing the correct diagnosis.

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Spiral CT Findings in Active and Remission Phases in Patients with Crohn Disease

Cited by 63 publications

References 14 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

Computed Tomography Target Sign: A Case of Mistaken Intussusception

Diseases of the cecum: a CT pictorial review

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