İnce Ali Tüzün, Baysal Birol, Kayar Yusuf, Arabacı Elif, Bilgin Mehmet, Hamdard Jamshid, Yay Adnan, Şentürk Hakan
Gastroenterology Clinic of Bezmialem Vakıf University İstanbul 34093, Turkey.
Department of Radiology, Bezmialem Vakıf University İstanbul 34093, Turkey.
Int J Clin Exp Med. 2014 Nov 15;7(11):4413-9. eCollection 2014.
Colonic wall thickening is a common condition in a number of benignant and malignant diseases. This study investigated the accuracy of radiological diagnoses in patients diagnosed with colonic wall thickening using multislice CT (MDCT).
Files of patients with colonic wall thickening diagnosed with 64-slice MDCT were reviewed retrospectively. The colonoscopy results of these patients were grouped under neoplastic process (cancer and adenomatous polyp), inflammatory bowel disease (IBD), diverticulitis and other etiology (nonspecific events, ischemic colitis, solitary rectal ulcer, external compression, secondary to volvulus and radiotherapy), and the results were statistically evaluated. p values < 0.05 were considered statistically significant.
The study was performed on 505 files (290 males [57.4%], 215 females [42.6%], mean age: 49.15 ± 18.4 years). CT and colonoscopic diagnoses were reviewed and the following CT to colonoscopy ratios was observed: neoplastic process: 44.4% vs. 40.2%; IBD: 42.4% vs. 42.4%; diverticulitis: 4% vs. 4.2%; other etiology: 9.3% vs. 3.2%. Colonoscopy failed to identify pathology in 9.9% of the patients. The sensitivity, specificity, PPV, NPV and accuracy of CT were 95.6%, 90.4%, 87.1%, 96.8% and 92.4%, respectively, in detecting neoplastic processes; 97.2%, 97.9%, 97.2%, 97.9% and 97.6%, respectively, in detecting IBD; 90.5%, 99.8%, 95%, 99.6% and 99.4%, respectively, in detecting diverticulitis, and 50%, 96,7%, 62.5%, 94.6% and 92%, respectively, in detecting other etiology.
While, accuracy of 64 slice-CT in diagnosing colonic wall thickenings secondary especially to neoplastic processes, IBD and diverticulitis was significantly higher, but differential diagnosis is challenging in pathologies due to other etiologies.
结肠壁增厚在多种良性和恶性疾病中较为常见。本研究调查了使用多层螺旋CT（MDCT）诊断结肠壁增厚患者的放射学诊断准确性。
回顾性分析经64层MDCT诊断为结肠壁增厚患者的病历。这些患者的结肠镜检查结果分为肿瘤性病变（癌症和腺瘤性息肉）、炎症性肠病（IBD）、憩室炎和其他病因（非特异性事件、缺血性结肠炎、孤立性直肠溃疡、外部压迫、继发于肠扭转和放疗），并对结果进行统计学评估。p值<0.05被认为具有统计学意义。
该研究共纳入505份病历（男性290例[57.4%]，女性215例[42.6%]，平均年龄：49.15±18.4岁）。对CT和结肠镜检查诊断进行回顾，观察到以下CT与结肠镜检查的诊断符合率：肿瘤性病变：44.4%对40.2%；IBD：42.4%对42.4%；憩室炎：4%对4.2%；其他病因：9.3%对3.2%。9.9%的患者结肠镜检查未发现病变。CT检测肿瘤性病变的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为95.6%、90.4%、87.1%、96.8%和92.4%；检测IBD分别为97.2%、97.9%、97.2%、97.9%和97.6%；检测憩室炎分别为90.5%、99.8%、95%、99.6%和99.4%；检测其他病因分别为50%、96.7%、62.5%、94.6%和92%。
虽然64层CT诊断尤其是继发于肿瘤性病变、IBD和憩室炎的结肠壁增厚的准确性显著更高，但对于其他病因导致的病变，鉴别诊断具有挑战性。
