title: Multi-detector CT-colonography in inflammatory bowel disease: prospective analysis of CT-findings to high-resolution video colonoscopy.
abstract: OBJECTIVE
  Prospective analysis of multi-detector CT-colonography (MDCTC) in patients with inflammatory bowel disease (IBD) compared to high-resolution video-endoscopy (HRVC).
  
  
  METHODS
  Twenty-one patients (mean age 49.6 years) with Crohn's disease or ulcerative colitis underwent MDCTC (Somatom Volume Zoom, Siemens, Erlangen; 1mm collimation, Pitch 8, 100 mAs, 120 kVp). HRVC was performed within 2 h after MDCTC. MDCTC was analyzed by two blinded readers. MDCTC-findings including bowel wall alterations and extraintestinal changes were compared to results of HRVC.
  
  
  RESULTS
  Over-all-sensitivity was 100% for endoluminal lesions with correct diagnosis of two cancers. Acute and chronic IBD were correctly identified by MDCTC in 63.6%, and 100%, respectively, with a specificity of 75%, and 100%. Sensitivity, specificity, positive and negative predictive values of MDCTC for diagnosis of acute and chronic disease were best for chronic disease. Sensitivity was worst for acute ulcerative colitis and specificity was worst for acute Crohn's disease. Haustral loss was seen only in ulcerative colitis. Pseudopolyps and fistulae were findings exclusive to Crohn's disease. Particularly extraintestinal findings as increased vascularization and local lymphadenopathy correlated well with endoscopic definition of acute disease. Because of the possibly more vulnerable colonic wall in acute inflammatory bowel disease, the air inflation for MDCTC should be performed most carefully to avoid any risk of colonic perforation.
  
  
  CONCLUSIONS
  MDCTC may help to distinguish between patients with acute and chronic IBD. Especially extraintestinal complications, tumorous as well as pseudo-tumorous lesions can be detected with high sensitivity and specificity.
authors.affiliation: Institute of Diagnostic Radiology, University Hospital Düsseldorf, Germany. kjel_andersen@web.de
authors.forename: Kjel
authors.initials: K
authors.lastname: Andersen
authors.forename: Christoph
authors.initials: C
authors.lastname: Vogt
authors.forename: Dirk
authors.initials: D
authors.lastname: Blondin
authors.forename: Andreas
authors.initials: A
authors.lastname: Beck
authors.forename: Wolfram
authors.initials: W
authors.lastname: Heinen
authors.forename: Volker
authors.initials: V
authors.lastname: Aurich
authors.forename: Dieter
authors.initials: D
authors.lastname: Häussinger
authors.forename: Ulrich
authors.initials: U
authors.lastname: Mödder
authors.forename: Mathias
authors.initials: M
authors.lastname: Cohnen
mesh_terms: D000328:Adult; D003093:Colitis, Ulcerative / Q000175:diagnosis* / Q000000981:diagnostic imaging; D023881:Colonography, Computed Tomographic / Q000379:methods*; D003113:Colonoscopy / Q000379:methods*; D003424:Crohn Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014741:Video Recording