Plastaras L, Vuitton L, Badet N, Koch S, Di Martino V, Delabrousse E
Department of Gastroenterology, University Hospital, 3 Boulevard Fleming, 25030 Besançon, France.
Department of Radiology, University Hospital, 3 Boulevard Fleming, 25030 Besançon, France.
Clin Radiol. 2015 Mar;70(3):262-9. doi: 10.1016/j.crad.2014.11.008. Epub 2014 Dec 16.
To investigate the utility of multidetector CT (MDCT) in helping to establish the underlying cause of acute colitis.
All patients who had acute colitis with a well-identified cause and underwent abdomen 64-MDCT were included in the study. MDCT images were retrospectively analysed in a blinded fashion and the CT findings were correlated with the eventual aetiological diagnosis.
The study population included 105 patients. Acute colitis was related to inflammatory bowel disease in 43 cases. MDCT was used to identify six relevant signs of inflammatory colitis: the "comb" sign (p < 0.001), enlarged lymph nodes (p < 0.001), abscess (p = 0.026), fibro-fatty infiltration (p = 0.007), small bowel involvement (p < 0.001), and the absence of an "empty colon" sign (p = 0.045). Multivariate logistic regression analysis identified three independent signs of inflammatory colitis: the "comb" sign, small bowel involvement, and enlarged lymph nodes. Acute colitis was related to bacterial infection in 35 cases. Five signs were significantly associated with infectious colitis: continuous distribution (p = 0.020), an "empty colon" sign (p = 0.002), absence of fat stranding (p = 0.013), and absence of a "comb" sign (p = 0.010) and absence of enlarged lymph nodes (p = 0.035). Multivariate analysis identified three independent signs: the "empty colon" sign and absence of fat stranding and of a "comb" sign. The remaining causes were ischaemic colitis (n = 21) and drug-related colitis (n = 6). MDCT examination provided five relevant signs of ischaemic colitis: fat stranding (p = 0.002), discontinuous distribution (p < 0.001), and absence of enlarged lymph node (p < 0.001), a "comb" sign (p = 0.006) and small bowel involvement (p = 0.037).
MDCT provides certain suggestive signs that may be helpful in distinguishing the underlying aetiological cause of acute colitis.
探讨多排螺旋CT（MDCT）在协助确定急性结肠炎潜在病因方面的作用。
本研究纳入了所有患有明确病因的急性结肠炎且接受腹部64排MDCT检查的患者。以盲法对MDCT图像进行回顾性分析，并将CT表现与最终的病因诊断进行关联。
研究人群包括105例患者。43例急性结肠炎与炎症性肠病有关。MDCT用于识别炎症性结肠炎的六个相关征象：“梳状”征（p < 0.001）、淋巴结肿大（p < 0.001）、脓肿（p = 0.026）、纤维脂肪浸润（p = 0.007）、小肠受累（p < 0.001）以及无“空肠”征（p = 0.045）。多因素逻辑回归分析确定了炎症性结肠炎的三个独立征象：“梳状 ”征、小肠受累和淋巴结肿大。35例急性结肠炎与细菌感染有关。五个征象与感染性结肠炎显著相关：连续分布（p = 0.020）、“空肠”征（p = 0.002）、无脂肪条纹（p = 0.013）、无“梳状”征（p = 0.010）和无淋巴结肿大（p = 0.035）。多因素分析确定了三个独立征象：“空肠”征以及无脂肪条纹和“梳状”征。其余病因包括缺血性结肠炎（n = 21）和药物相关性结肠炎（n = 6）。MDCT检查提供了缺血性结肠炎的五个相关征象：脂肪条纹（p = 0.002）、不连续分布（p < 0.001）、无淋巴结肿大（p < 0.001）、“梳状”征（p = 0.006）和小肠受累（p = 0.037）。
MDCT提供了某些提示性征象，可能有助于区分急性结肠炎的潜在病因。
