|
KMID : 0386119960350020229
|
|
Journal of the Korean Radiological Society
1996 Volume.35 No. 2 p.229 ~ p.235
|
|
|
Ischemic Colitis Proximal to Obstruction Colonic Carcinoma: Values of CT in Its Detection
|
|
고기영
하현권/이문규/김표년/김남현/서미라/손세호/오용호
|
|
|
Abstract
|
|
|
Purpose:
@EN To determine the value of the CT scan in distinguishing an ischemic and a tumoral segment in colonic carcinoma complicated by proximal bowel ischemia.
@ES Materials and Methods:
@EN CT scans of twenty patients with ischemic colitis proximal to obstructing colonic carcinoma were reviewed retrospectively. The presence of an ischemic segment proximal to colonic carcinoma were pathologically confirmed in 12 patients. And the
remaining eight patients showed typical radiologic findings of bowel ischemia on barium enema but on pathologic review showed only colonic carcinoma. CT scans were analyzed for the location, wall thickness, length, and enhancing pattern of both
tumoral
and ischemic segments in correlation with barium enema or surgico-pathologic results. The results of tumor staging shown on CT scan were compared with those of pathologic findings.
@ES Results:
@EN On CT scan a distinction between ischemic and tumoral segments could be made in 15 patients (75%). The ischemic segments were contiguously proximal to the tumoral segment in 18 patients. In two patients, however, there was an intervening
segment of
normal bowel between the two segments and this was confirmed by pathology. Maximvm bowel wall thickness ranged from 0.8 to 4.5 cm (mean, 2.0 cm) in tumoral segments and from 0.6 to 1.5 cm (mean, 1.0 cm) in ischemic segments (p<0.05). Tumoral
segments
were enhanced heterogeneously in 12 patients (60%) and homogeneously in the remaining eight, while ischemic segments were enhanced homogeneously in 14 patients (70%) and heterogeneously in six. Peripheral rim enhancement was seen only in the
ischemic
segments of four patients (20%). Comparing TNM tumor staging of the CT scan with that of pathology, CT scan overstaged in two patients (10%) and understaged in one (5%).
@ES Conclusion:
@EN CT is a valuable tool for distinguishing an ischemic from a tumoral segment in patients with ischemic colitis proximal to colonic carcinoma. An understanding of this pathologic entity could reduce the possibility of over or understaging in
cases of
colonic carcinoma.
|
|
|
KEYWORD
|
|
|
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
 
|