| CT enterography and fistulizing Crohn's disease: clinical benefit and radiographic findings. | |
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MedLine Citation:
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PMID: 18551336 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: To estimate the clinical benefit of CT enterography (CTE) in patients with fistulizing Crohn's disease and describe the appearance of fistulas at CTE. METHODS: Crohn's patients who had undergone CTE, which diagnosed an abscess or fistula, were identified. A gastroenterologist reviewed clinical notes prior to and following CTE to assess the pre-CTE clinical suspicion for fistula/abscess, and post-CTE alteration in patient management. A radiologist reassessed all fistula-positive cases, which were confirmed by a non-CT reference standard, to describe their radiologic appearance. RESULTS: Fifty-six patients had CT exams identifying 19 abscesses and 56 fistulas. There was no or remote suspicion of fistula or abscess at pre-imaging clinical assessment in 50% of patients. Thirty-four patients (61%) required a change in or initiation of medical therapy and another 10 (18%) underwent an interventional procedure based on CT enterography findings. Among 37 fistulas with reference standard confirmation, 30 (81%) were extraenteric tracts, and 32 (86%) were hyperenhancing compared to adjacent bowel loops. Most fistulas (68%) contained no internal air or fluid. CONCLUSION: CTE detects clinically occult fistulas and abscesses, resulting in changes in medical management and radiologic or surgical intervention. Most fistulas appear as hyperenhancing, extraenteric tracts, usually without internal air or fluid. |
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Authors:
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Fargol Booya; Salma Akram; Joel G Fletcher; J E Huprich; C D Johnson; J L Fidler; J M Barlow; C A Solem; W J Sandborn; Edward V Loftus |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Abdominal imaging Volume: 34 ISSN: 1432-0509 ISO Abbreviation: Abdom Imaging Publication Date: 2009 Jul |
Date Detail:
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Created Date: 2009-07-29 Completed Date: 2009-10-29 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9303672 Medline TA: Abdom Imaging Country: United States |
Other Details:
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Languages: eng Pagination: 467-75 Citation Subset: IM |
Affiliation:
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Department of Radiology, Mayo Clinic Rochester, Rochester, MN 55905, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Abscess
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etiology,
radiography* Adult Crohn Disease / complications, radiography* Female Humans Intestinal Fistula / etiology, radiography* Male Middle Aged Retrospective Studies Tomography, X-Ray Computed / methods* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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