title: Collagenous sprue cross-sectional imaging: a comparative blinded study.
abstract: Collagenous sprue (CS) is a rare enteropathy characterized by villous atrophy and a thickened subepithelial collagen band. The aim of this study is to describe the cross-sectional imaging findings of CS.
  
  
  
  A case-control, retrospective study with cases of all CS patients from January 2000 to 2015 was performed. Inclusion criteria were (1) Histopathologic diagnosis and (2) Imaging with computed tomography abdomen/pelvis (CT A/P), CT enterography (CTE), or magnetic resonance enterography within 6 months of small bowel (SB) biopsy. Control subjects were irritable bowel syndrome (IBS) patients who underwent CTE. Imaging studies were examined by two GI radiologists, blinded to patient data.
  
  
  
  108 patients (54 CS; 54 IBS) were included. Mean age was 56.7 ± 16.5 years, and 68% were female (72% in CS group vs. 63% in IBS group; p = 0.3). CS patients were significantly older (67 ± 12 vs. 47 ± 15 year; p < 0.001) and more likely to be on angiotensin receptor blockers (41% vs. 6%; p < 0.001) as compared to the IBS group. Compared to IBS, CS patients were more likely to have mesenteric lymph node (LN) prominence (56% vs. 15%; p < 0.001), jejunoileal fold pattern reversal (46% vs. 6%; p < 0.001), SB dilation (28% vs. 0%; p < 0.001), SB conformational change (28% vs. 6%; p = 0.002), SB wall thickening (13% vs. 2%; p = 0.03), and ulcerative jejunoileitis (4% vs. 0%; p = 0.01). Radiologists suspected malabsorption in 72% in the CS group and 2% in the IBS group (p < 0.001).
  
  
  
  Imaging findings suggestive of mucosal malabsorption are commonly demonstrated in CS.
authors.affiliation: Department of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street S.W., Rochester, MN, 55905, USA. albawardy.badr@mayo.edu.
authors.forename: Badr
authors.initials: B
authors.lastname: Al-Bawardy
authors.affiliation: Department of Radiology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Shannon P
authors.initials: SP
authors.lastname: Sheedy
authors.affiliation: Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.
authors.forename: Michelle B
authors.initials: MB
authors.lastname: Herberts
authors.affiliation: Department of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street S.W., Rochester, MN, 55905, USA.
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Murray
authors.affiliation: Department of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street S.W., Rochester, MN, 55905, USA.
authors.forename: Alberto
authors.initials: A
authors.lastname: Rubio-Tapia
authors.affiliation: Department of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street S.W., Rochester, MN, 55905, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Rajan
authors.affiliation: Department of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street S.W., Rochester, MN, 55905, USA.
authors.forename: David H
authors.initials: DH
authors.lastname: Bruining
authors.affiliation: Department of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street S.W., Rochester, MN, 55905, USA.
authors.forename: Stephanie L
authors.initials: SL
authors.lastname: Hansel
authors.affiliation: Department of Radiology, Mayo Clinic, Rochester, MN, USA.
authors.forename: John M
authors.initials: JM
authors.lastname: Barlow
authors.affiliation: Department of Radiology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Joel G
authors.initials: JG
authors.lastname: Fletcher
authors.affiliation: Department of Radiology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Jeff L
authors.initials: JL
authors.lastname: Fidler
mesh_terms: D016022:Case-Control Studies; D064068:Collagenous Sprue / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
keywords: CT enterography; Collagenous sprue; Enteropathy; MR enterography; Olmesartan