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The Role of Multislice
CT in Evaluation of Chronic Inflammatory Bowel Disease
Ahmed Hamimi (1), Hanan Moursy(1), Ahmed
Mehalel(1) & Mohamed Tamer Afifi(2)
Departments of Radiology(1) & Internal Medicine (2),
Faculty of Medicine, Alexandria University, Egypt
Tanta Med. Sc. J 2008; 3(4):107-117
Article type: Original article
Background/Aim: Ulcerative colitis (UC) and Crohn's disease (CD) are
the two main subtypes of chronic inflammatory bowel diseases (IBD).
Multidetector computed tomography (CT) has been recognized as a
promising modality for the evaluation of Crohn's disease and other
small-bowel abnormalities. CT enterography differs from routine
abdominal CT in that CT enterography uses multidetector CT (narrow
section thickness and reconstruction interval), intravenous contrast
material, and large volumes of a neutral oral contrast agent to
improve depiction of the small-bowel wall and lumen. In patients
with Crohn's disease, CT enterography is increasingly used to detect
enteric inflammation in addition to extra-enteric complications. The
aim of the work will be directed to identify the role of MSCT in the
evaluation of idiopathic inflammatory bowel diseases. Patients &
Methods: The present work included 30 patients suffering from
idiopathic inflammatory bowel disease (ulcerative colitis or Crohn’s
disease. All patients subjected to CT enterography and/or
colonography using multi-detector row CT and iso-osmotic mannitol as
neutral enteric contrast material & Ileo-colonoscopy and mucosal
biopsy. Results: CT findings include abnormal wall thickening
(generally 1 cm) with skip areas of colonic stenosis and dilatation.
Associated findings include pericolonic fat stranding, fistulas,
abscesses, fibro fatty proliferation, and mesenteric adenopathy.
Findings such as mural thickening, mural enhancement, increased
attenuation of the perienteric fat, and the comb sign have been
reported to indicate active inflammatory Crohn's disease.
Conclusion: MSCT is a great diagnostic tool in detecting and
assessing early changes of inflammatory bowel disease as well as
monitoring the disease progress and evaluating the complication.
ICID 885184 |