title: Bowel wall thickening in patients with Crohn's disease: CT patterns and correlation with inflammatory activity.
abstract: OBJECTIVE
  To assess CT patterns of bowel wall thickening in patients with Crohn's disease and to correlate these patterns with inflammatory activity.
  
  
  METHODS
  We conducted a retrospective review of 58 helical abdominal CT scans of 53 patients with pathologically proven Crohn's disease. CT patterns of thickened bowel wall were divided into four types based on patterns of mural stratification and enhancement: type A, multilayered mural stratification; type B, two layers with strong mucosal enhancement and prominent low-density submucosa; type C, two layers without strong mucosal enhancement; and type D, homogeneous enhancement. We evaluated CT findings of the bowel and adjacent structures. We also reviewed pathologic features and clinical data to determine inflammatory activity.
  
  
  RESULTS
  Fifty-five (95%) of 58 CT examinations showed bowel wall thickening. Of these 55 CT scans, type A pattern was found in 33 (60%), type B in 10 (18%), type C in five (9%), and type D in seven (13%). CT scans with type A showed significantly more wall thickening than those with either type C or type D. Histology revealed 43 cases with active disease and 12 with quiescent appearance. Thirty of 33 CT scans with type A and all 10 with type B were classified as acute disease, and three of five with type C and six of seven with type D as quiescent.
  
  
  CONCLUSIONS
  In patients with Crohn's disease, CT patterns of bowel wall thickening correlated with inflammatory activity. Thickened bowel wall with layering enhancement is predictive of acute disease, and that of homogeneous enhancement suggests quiescence.
authors.affiliation: Department of Radiology, Kangbuk Samsung Hospital, Kangbuk Samsung Hospital, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Dongil
authors.initials: D
authors.lastname: Choi
authors.forename: Soon
authors.initials: S
authors.lastname: Jin Lee
authors.forename: Young
authors.initials: Y
authors.lastname: Ah Cho
authors.forename: Hyo K
authors.initials: HK
authors.lastname: Lim
authors.forename: Seung
authors.initials: S
authors.lastname: Hoon Kim
authors.forename: Won
authors.initials: W
authors.lastname: Jae Lee
authors.forename: Jae
authors.initials: J
authors.lastname: Hoon Lim
authors.forename: Haewon
authors.initials: H
authors.lastname: Park
authors.forename: Young
authors.initials: Y
authors.lastname: Rae Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D003106:Colon / Q000000981:diagnostic imaging* / Q000473:pathology; D003424:Crohn Disease / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods