Researchers from Madrid, Spain, investigated helical computed tomography (HCT) findings, in both active and remission phases, in patients with Crohn's disease.
They evaluated the radiologic findings that are useful in differentiating between the two phases.
Some 50 Crohn's patients were classified into active or remission phases (n = 37 and n = 13, respectively) according to clinical criteria and laboratory data.
All individuals underwent an abdominal HCT exploration.
The team evaluated several radiologic findings. These were thickness, density, and enhancement of the bowel wall, presence of "target" or "double halo", mesenteric involvement, and possible complications.
All patients in the active phase had pathologic findings on HCT.
The wall thickness was 8.5 and 6.5 mm in active and remission phases, respectively.
| Radiologic findings in active Crohn's disease:|
- Bowel wall enhancement
- Mesentery involvement
| Journal of Computer Assisted Tomography |
Target was found to be present in 7 patients (19%) with active disease, and in 5 patients (39%) in the remission phase.
Density of the wall in the active and remission phases were 95 and 65 HU, respectively.
The researchers found that mesentery was involved in 89% of patients in the active phase, and 38% of patients in the remission phase.
The complications observed in patients with active-phase disease were abscesses in 9, phlegmons in 2, fistulas in 3, intestinal obstruction in 2, and pancreatitis in 1.
Author Lourdes Del Campo concluded on behalf of the team, "A normal HCT rules out that a patient with Crohn's is in the active phase of disease.
"The presence of significant bowel wall enhancement and mesentery involvement assists in the differentiation of patients in the active phase from those in remission.
"HCT is also effective in assessing the presence of complications, which are indicative of the active phase."