Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan.
Department of Medical Imaging, Chi Mei Medical Center, Tainan, Taiwan.
Kaohsiung J Med Sci. 2024 Mar;40(3):296-303. doi: 10.1002/kjm2.12761. Epub 2023 Sep 21.
Clinical manifestations of phlebosclerotic colitis (PC) exhibit significant variability, necessitating diverse treatment strategies depending on disease severity. However, there is limited research exploring the relationship between imaging findings and disease severity. Hence, this retrospective study aimed to analyze the correlation between computed tomography (CT) findings, colonoscopic features, and disease severity. This study compared the abdominal CT characteristics, colonoscopy findings, and treatment modalities of 45 PC patients. CT images were assessed for the severity of mesenteric venous calcification, maximum colonic wall thickness, number of involved colonic segments, and presence of pericolic inflammation. Colonoscopic images were assessed for dark purple discoloration mucosa, erosive and ulcerative lesions, mucosal edema, luminal narrowing, and the number of involved colonic segments. In addition, patients were categorized into three groups: the observation (n = 15), medical treatment (n = 19), and operation (n = 11) groups. In CT images, a significant difference in pericolic inflammation (p = 0.039) was observed among groups. Further, significant differences in dark purple discoloration mucosa (p = 0.033), erosive or ulcerative lesions (p < 0.001), mucosal edema (p < 0.001), luminal narrowing (p = 0.012), and the number of involved colonic segments (p = 0.001) were observed in colonoscopy. Moreover, we found positive correlations between CT and colonoscopy features. In conclusion, CT manifestations and colonoscopy findings exhibited correlation with disease severity in PC. When limited to one diagnostic tool, observations from that tool can infer potential manifestations of the alternative tool.
静脉性硬化性结肠炎(PC)的临床表现存在显著差异,需要根据疾病严重程度采用不同的治疗策略。然而,目前针对影像学表现与疾病严重程度之间的关系的研究有限。因此,本回顾性研究旨在分析计算机断层扫描(CT)表现、结肠镜特征与疾病严重程度之间的相关性。该研究比较了 45 例 PC 患者的腹部 CT 特征、结肠镜检查结果和治疗方式。CT 图像用于评估肠系膜静脉钙化严重程度、结肠壁最大厚度、受累结肠节段数量和结肠周围炎症情况。结肠镜图像用于评估黏膜暗紫色变色、糜烂和溃疡病变、黏膜水肿、管腔狭窄和受累结肠节段数量。此外,患者分为观察(n=15)、药物治疗(n=19)和手术(n=11)组。在 CT 图像中,各组之间的结肠周围炎症存在显著差异(p=0.039)。此外,在结肠镜下,暗紫色变色黏膜(p=0.033)、糜烂或溃疡病变(p<0.001)、黏膜水肿(p<0.001)、管腔狭窄(p=0.012)和受累结肠节段数量(p=0.001)方面也存在显著差异。而且,我们发现 CT 与结肠镜特征之间存在正相关关系。总之,CT 表现和结肠镜检查结果与 PC 的疾病严重程度相关。当仅局限于一种诊断工具时,该工具的观察结果可以推断出另一种工具的潜在表现。