Author of 1 Presentation
SS 9.6 - Severe ischemic colitis: CT findings and histopathological correlation (ID 473)
Abstract
Purpose
To identify CT findings in patients with acute ischemic colitis (AIC) surgically treated and to correlate them with the severity of the colonic necrosis in histopathology.
Material and methods
CT data of 50 consecutive patients with AIC surgically treated were independently reviewed retrospectively by 3 radiologists. Histopathological slides were reviewed by an experimented pathologist to assess patients with no or limited necrosis to the mucosa or submucosa and those with extended necrosis and to compare CT features in each group. Interobserver agreement (K) was assessed for each CT finding.
Results
Twenty-five patients (50%) were classified as group limited necrosis and 25 patients (50%) as group extended necrosis. The most frequent CT signs observed were the abnormal wall enhancement (76%) and colon wall thickening or thinning (82 and 70%, respectively). Parietal pneumatosis (PP) was found in 8 patients (32%) of the group extended necrosis against 2 (8%) in the group limited necrosis (p: 0.024) with a sensibility for detection of extended necrosis of 0.32 (95% confidence interval [95% CI], 0.15 - 0.53) and a specificity of 0.92 (95% CI, 0.74 – 0.99).Portomesenteric venous gas (PVMG) was mostly seen in the group with limited necrosis (5/6 patients, K: 1). Three cases of increased unenhanced colonic wall attenuation and 3 of intra-luminal blood clot were observed.
Conclusion
PP is a significant sign of severe colonic necrosis in the clinical context of AIC. Isolated PVMG should be considered carefully because it could be associated with less extensive necrosis.
Presenter of 1 Presentation
SS 9.6 - Severe ischemic colitis: CT findings and histopathological correlation (ID 473)
Abstract
Purpose
To identify CT findings in patients with acute ischemic colitis (AIC) surgically treated and to correlate them with the severity of the colonic necrosis in histopathology.
Material and methods
CT data of 50 consecutive patients with AIC surgically treated were independently reviewed retrospectively by 3 radiologists. Histopathological slides were reviewed by an experimented pathologist to assess patients with no or limited necrosis to the mucosa or submucosa and those with extended necrosis and to compare CT features in each group. Interobserver agreement (K) was assessed for each CT finding.
Results
Twenty-five patients (50%) were classified as group limited necrosis and 25 patients (50%) as group extended necrosis. The most frequent CT signs observed were the abnormal wall enhancement (76%) and colon wall thickening or thinning (82 and 70%, respectively). Parietal pneumatosis (PP) was found in 8 patients (32%) of the group extended necrosis against 2 (8%) in the group limited necrosis (p: 0.024) with a sensibility for detection of extended necrosis of 0.32 (95% confidence interval [95% CI], 0.15 - 0.53) and a specificity of 0.92 (95% CI, 0.74 – 0.99).Portomesenteric venous gas (PVMG) was mostly seen in the group with limited necrosis (5/6 patients, K: 1). Three cases of increased unenhanced colonic wall attenuation and 3 of intra-luminal blood clot were observed.
Conclusion
PP is a significant sign of severe colonic necrosis in the clinical context of AIC. Isolated PVMG should be considered carefully because it could be associated with less extensive necrosis.