CT of prominent pericolic or perienteric vasculature in patients with Crohn's disease: correlation with clinical disease activity and findings on barium studies.
OBJECTIVE. The purpose of this study was to correlate CT findings of prominent pericolic or perienteric vasculature with clinical disease activity, treatment methods, and barium enema study findings in patients with Crohn's disease.


METHODS
We retrospectively analyzed 33 patients with Crohn's disease who had undergone both barium enema study and abdominal CT. CT scans were evaluated for the presence and location of prominent vasculature. On the basis of the Crohn's disease activity index, the patients were assigned to one of three categories--active, intermediate, or quiescent disease groups--and the frequency of prominent vasculature was compared among them. Thereafter, erythrocyte sedimentation rates, C-reactive protein levels, treatment methods, and radiographic findings were compared in groups with and without prominent vasculature.


RESULTS
Prominent vasculature was more frequently found in patients with active disease (81%) than in those with intermediate (33%) and quiescent disease (0%) (p < 0.001). The erythrocyte sedimentation rates and C-reactive protein levels were higher in patients with prominent vasculature (but not at a statistically significant rate). Patients with prominent vasculature were more frequently admitted to the hospital (p = 0.024) and received more aggressive treatment (p = 0.049) than patients without prominent vasculature. The main differences of radiographic findings between the group with prominent vasculature and the group without prominent vasculature included the common occurrence of longitudinal and perpendicular ulceration (p = 0.017 for small bowel; p = 0.041 for colon) and the extensive length of organ involvement (p = 0.004 for small bowel; p = 0.036 for colon).


CONCLUSIONS
Prominent pericolic or perienteric vasculature seen on CT in patients with Crohn's disease suggests that the disease is clinically active, advanced, and extensive and that these patients require more aggressive treatment than patients without this CT finding.
Lee
Seung Soo
SS
Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Poongnap-dong, Songpa-gu, Seoul, 138-736, Korea.
Ha
Hyun Kwon
HK
Yang
Suk-Kyun
SK
Kim
Ah Young
AY
Kim
Tae Kyoung
TK
Kim
Pyo Nyun
PN
Lee
Moon-Gyu
MG
Myung
Seung-Jae
SJ
Jung
Hwoon-Yong
HY
Kim
Jin Ho
JH
Min
Young Il
YI
D000293:Adolescent; D000328:Adult; D000368:Aged; D000792:Angiography; D001466:Barium Sulfate; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000032:analysis; D003106:Colon / Q000098:blood supply / Q000000981:diagnostic imaging; D003287:Contrast Media; D003424:Crohn Disease / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000628:therapy; D004733:Enema; D005260:Female; D006801:Humans; D007421:Intestine, Small / Q000098:blood supply / Q000000981:diagnostic imaging; D007422:Intestines / Q000098:blood supply* / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
D003287:Contrast Media; D001466:Barium Sulfate; D002097:C-Reactive Protein