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MDCT assessment of ulcerative colitis: radiologic analysis with clinical, endoscopic, and pathologic correlation

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Abstract

Purpose

Evaluate the utility of multidetector-row computed tomography (MDCT) in assessing the severity of ulcerative colitis (UC) in comparison with clinical assessment, colonoscopy, and histopathology.

Materials and methods

Patients with UC evaluated with at least one abdominal contrast-enhanced CT study (CECT) within 7 days of colonoscopy with biopsy were included. CECT of 23 patients (12 male; mean age 40 years; age range, 20–72 years) were retrospectively evaluated in consensus by two radiologists. A total of 138 lower GI tract segments were evaluated by CECT and graded for the presence of bowel wall thickening, mucosal hyperenhancement, mural stratification, mesenteric hyperemia, pericolonic stranding, and lymph nodes. A cumulative CT severity score was calculated and correlated with clinical, colonoscopic, and histopathologic severity grades.

Results

The cumulative CT score and individual CECT scores for bowel wall thickening, mucosal hyperenhancement, and mural stratification showed positive correlation with clinical severity (P < 0.05). All individual CECT features as well as the cumulative CT score demonstrated statistically significant correlation with colonoscopic severity (P < 0.0001). Only wall thickening on CECT demonstrated significant correlation with histopathologic severity (P = 0.01).

Conclusion

Disease severity assessment by MDCT demonstrates positive correlation with severity established by clinical assessment and colonoscopy. Only increasing wall thickness, as graded on MDCT, correlates with histopathologic disease severity.

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Authors and Affiliations

  1. Division of Abdominal Imaging & Intervention, Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Bijal Patel, Jeffrey Mottola, V. Anik Sahni, Vito Cantisani, Andrea Marcantonio & Koenraad J. Mortele

  2. Division of Gastroenterology, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Sonia Friedman

  3. Department of Radiology, La Sapienza Hospital, Rome, Italy

    Vito Cantisani & Andrea Marcantonio

  4. Department of Radiology, Sisli Etfal Training and Research Hospital, Istanbul, Turkey

    Mehmet Ertruk

  5. Department of Pathology, Brigham and Women’s Hospital, Boston, MA, USA

    Andrew M. Bellizzi

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  1. Bijal Patel
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Correspondence to Bijal Patel.

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Patel, B., Mottola, J., Sahni, V.A. et al. MDCT assessment of ulcerative colitis: radiologic analysis with clinical, endoscopic, and pathologic correlation. Abdom Imaging 37, 61–69 (2012). https://doi.org/10.1007/s00261-011-9741-x

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