Spiral CT colonography in inflammatory bowel disease

Objective: Most of the studies on virtual colonoscopy are dealing with the role of detecting colorectal polyps or neoplasms. We have undertaken this s tudy to evaluate the value of CT colonography in patients with colonic Croh n's disease. Methods and material: Five patients (three males, two females, 23-51 years, mean age 42 years) with known (4) or suspected (1) Crohn's di sease of the colon underwent fiberoptic colonoscopy and CT colonography in the same day or during a I-week period. The images were evaluated with the so called zoomed axial slice movie technique and in some regions intra- and extraluminal surface shaded and Volume rendered images were generated on a separate workstation. The results were compared to those of a colonoscopy. Results: The final diagnosis was Crohn's disease in four patients and coli tis ulcerosa in one. Total examination was possible by colonoscopy in two c ases, and with CT colonography in all five cases. The wall of those segment s severely affected by the disease were depicted by the axial CT scans to b e thickened. The thick walled, segments with narrow lumen seen on CT colono graphy corresponded to the regions where colonoscopy was failed to pass. Ai r filled sinus tracts, thickening of the wall of the terminal ileum, loss o f haustration pseudopolyps and deep ulcers were seen in CT colonography. Th ree dimensional (3D) endoluminal views demonstrated pseudopolyps similar to endoscopic images None of the colonoscopically reported shallow ulceration s or aphtoid ulcerations or granular mucosal surface were observed on 2- or 3D CT colonographic images. Conclusion: CT colonography by depicting colon ic wall thickening seems to be a useful tool in the diagnosis of Crohn's co litis, which could be a single examination depicting the intraluminal, and transmural extent of the disease. (C) 2000 Published by Elsevier Science Ir eland Ltd.