Value of Mult-Slice Spiral CT for Nontumorous Bowel Wall Thickening_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

CHEN Guangwen , SONG Bin , WU Bi , ZHAO Liming , YANG Ningjing

Department of Radiology,West China Hospital,Sichuan University,Chengdu 610041,ChinaCorresponding Author： SONG Bin, E-mail：cjr.songbin@vip.163.com;

Corresponding author：

Keywords：

Bowel wall thickening; Computed tomography/X-ray

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Objective To investigate the mult-slice spiral CT(MSCT)imaging manifestations of bowel wall thickening due to nontumorous causes,and to address the value of MSCT scanning in assessing nontumorous bowel wall thickening.
MethodsThe MSCT findings of 284 patients with bowel wall thickening due to nontumorous causes confirmed by surgery,biopsy,or clinical follow-up were retrospectively analyzed.The location, range,symmetric or asymmetric,degree,attenuation,presence or absence of enhancement and associated perienteric abnormalities of thickened bowel wall were involved.
ResultsAll nontumorous disease caused bowel wall thickening include liver cirrhosis(109 cases),acute pancreatitis(54 cases),bowel obstruction(36 cases),inflammatory bowel disease(14 cases),ischemic bowel disease(12 cases),radiation enterocolitis(13 cases),tuberculosis(12 cases),immune reaction(10 cases),infective enteritis(3 cases),acute appendicitis(3 cases),hypoproteinemia(5 cases),non-common disease(8 cases)and normal variants(5 cases).The attenuation pattern of the thickened bowel wall include high attenuation(1 case),iso-attenuation(144 cases),low attenuation(127 cases),fat deposition(5 cases)and pneumatosis(7 cases).The enhancement pattern of the thickened bowel wall included gentle enhancement(249 cases),notable enhancement(32 cases)and unenhancement(3 cases).Degree of bowel wall thickening included mild thinckening(279 cases)and marked thickening(5 cases).The range of bowel wall thickening was focal(8 cases),segmental(64 cases)and diffuse(212 cases).The associated perienteric abnormalities of thickened bowel wall included swelling of fat(218 cases),ascites(189 cases),lymphadenopathy(5 cases),peirenteirc abscess(2 cases),mesenteric vascular lesion(25 cases)and involvement of solid abdominal organs(169 cases). ConclusionMSCT has an invaluable role in the diagnostic evaluation of nontumorous bowel wall thickening.A wide variety of nontumorous diseases may manifest with bowel wall thickening at MSCT.Paying attention to the characteristics of thickening of bowel wall will benefit the diagnosis and differential diagnosis of various intestinal diseases.

Citation： CHEN Guangwen,SONG Bin,WU Bi,ZHAO Liming,YANG Ningjing. Value of Mult-Slice Spiral CT for Nontumorous Bowel Wall Thickening. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2009, 16(2): 164-169. doi: Copy

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7.	Furukawa A, Saotome T, Yamasaki M, et al. Cross-sectional imaging in Crohn disease [Ｊ]. Radiographics, 2004; 24(3)：689.
8.	Horton KM, Fishman EK. Multi-detector row CT of mesenteric ischemia: can it be done? [Ｊ]. Radiographics, 2001; 21(6)：1463.
9.	Ahualli J. The target sign: bowel wall [Ｊ]. Radiology, 2005; 234(2)：549.
10.	Ahualli J. The fat halo sign [Ｊ]. Radiology. 2007; 242(3)：945.
11.	Chou CK, Wu RH, Mak CW, et al. Clinical significance of poor CT enhancement of the thickened small bowel wall in patients with acute abdominal pain [Ｊ]. AJR Am J Roentgenol, 2006; 186(2)：491.
12.	Karahan OI, Dodd GD 3rd, Chintapalli KN, et al. Gastrointestinal wall thickening in patients with cirrhosis: frequency and patterns at contrast enhanced CT [Ｊ]. Radiology, 2000; 215(1)：103.
13.	吴苾，宋彬.影像学新技术在消化系统的临床应用[Ｊ].中国普外基础与临床杂志， 2007； 14(2)：222.

1. Gore RM, Balthazar EJ, Ghahremani GG, et al. CT features of ulcerative colitis and Crohn’s disease [Ｊ]. AJR Am J Roentgenol, 1996; 167(1)：3.
2. Macari M, Balthazar EJ. CT of bowel wall thickening: significance and pitfalls of interpretation [Ｊ]. AJR Am J Roentgenol, 2001; 176(5)：1105.
3. Wittenberg J, Harisinghani MG, Jhaveri K, et al. Algorithmic approach to CT diagnosis of the abnormal bowel wall [Ｊ]. Radiographics, 2002; 22(5)：1093.
4. Madureira AJ. The comb sign [Ｊ]. Radiology, 2004; 230(3)：783.
5. d’Almeida M, Jose J, Oneto J, et al. Bowel wall thickening in children: CT findings [Ｊ]. Radiographics, 2008; 28(3)：727.
6. 李迎春，宋彬，印隆林，等.16层螺旋CT多平面重建技术对肠梗阻的诊断价值[Ｊ].中国普外基础与临床杂志， 2006； 13(5)：608.
7. Furukawa A, Saotome T, Yamasaki M, et al. Cross-sectional imaging in Crohn disease [Ｊ]. Radiographics, 2004; 24(3)：689.
8. Horton KM, Fishman EK. Multi-detector row CT of mesenteric ischemia: can it be done? [Ｊ]. Radiographics, 2001; 21(6)：1463.
9. Ahualli J. The target sign: bowel wall [Ｊ]. Radiology, 2005; 234(2)：549.
10. Ahualli J. The fat halo sign [Ｊ]. Radiology. 2007; 242(3)：945.
11. Chou CK, Wu RH, Mak CW, et al. Clinical significance of poor CT enhancement of the thickened small bowel wall in patients with acute abdominal pain [Ｊ]. AJR Am J Roentgenol, 2006; 186(2)：491.
12. Karahan OI, Dodd GD 3rd, Chintapalli KN, et al. Gastrointestinal wall thickening in patients with cirrhosis: frequency and patterns at contrast enhanced CT [Ｊ]. Radiology, 2000; 215(1)：103.
13. 吴苾，宋彬.影像学新技术在消化系统的临床应用[Ｊ].中国普外基础与临床杂志， 2007； 14(2)：222.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Value of Mult-Slice Spiral CT for Nontumorous Bowel Wall Thickening

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