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首页> 外文期刊>Clinical imaging >Toxic megacolon in patients with severe acute colitis: Computed tomographic features
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Toxic megacolon in patients with severe acute colitis: Computed tomographic features

机译：重症急性结肠炎患者的有毒巨结肠：计算机断层扫描特征

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Objective: The objective of the study was to evaluate computed tomography (CT) in the differential diagnosis of patients with toxic megacolon (TM) complicating severe acute colitis (SAC) and patients with SAC but no TM. Materials and methods: We identified 16 patients who presented clinically complicated SAC and CT examination before surgery. The CT scans of these patients were retrospectively evaluated in consensus by two abdominal radiologists blinded to the clinical and pathological results for CT findings of SAC, i.e., diffuse colonic wall thickening, submucosal edema, pericolonic fat stranding and ascites, and CT findings of TM reported in the literature, i.e., segmental colonic wall thinning, air-filled colonic distension over 6 cm with abnormal haustral pattern, nodular pseudopolyps and associated small bowel distension. Fisher's Exact Test was used for all statistical analyses. Results: Segmental colonic wall thinning with abnormal haustral pattern was noted in TM only (P=001). As compared to patients with SAC but no TM as a complication, patients with TM showed statistically more frequent air-filled colonic distension over 6 cm (P=001) and nodular pseudopolyps (P=001). Diffuse colonic wall thickening (P=036) and submucosal edema (P=036) were more present in cases of uncomplicated SAC. Pericolonic fat stranding (P=12), ascites (P=6), and small bowel and gastric distension (P=1) were not distinctive criteria. Conclusion: Computed tomography is useful in distinguishing patients with TM from patients with SAC but no TM as a complication. The association of air-filled colonic distension >6 cm, abnormal haustral pattern and segmental colonic parietal thinning seems pathognomonic of TM and should lead to rapid surgery.
机译：目的：本研究的目的是评估计算机断层扫描（CT）在鉴别并发重症急性结肠炎（SAC）的中毒性巨结肠（TM）患者和无TM的SAC患者中的鉴别诊断。材料和方法：我们确定了16例在手术前进行了临床复杂的SAC和CT检查的患者。两名腹部放射科医生对SAC的CT表现（即弥漫性结肠壁增厚，粘膜下水肿，结肠结肠脂肪搁浅和腹水）不知临床和病理结果，对这些患者的CT扫描进行了回顾性评估，结果一致。在文献中，即节段性结肠壁变薄，充气性结肠扩张超过6 cm且具有异常的腹腔纹样，结节性假性息肉和相关的小肠扩张。所有统计分析均使用Fisher精确检验。结果：仅在TM中发现节段性结肠壁变薄且具有异常的腹侧模式（P = 001）。与SAC但无TM并发症的患者相比，TM患者在6 cm（P = 001）和结节性假性息肉（P = 001）上表现出更为频繁的充气结肠扩张。在无并发症的SAC病例中，弥漫性结肠壁增厚（P = 036）和粘膜下水肿（P = 036）更为常见。围产期脂肪搁浅（P = 12），腹水（P = 6），小肠和胃胀（P = 1）不是区别标准。结论：计算机断层扫描有助于区分TM患者和SAC患者，但无TM并发症。充气性结肠扩张> 6 cm，腹侧异常形态和节段性结肠顶壁变薄的相关性似乎是TM的病因学表现，应导致快速手术。

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