Multidetector-row computed tomography enterographic assessment of the ileal-anal pouch: Descriptive radiologic analysis with endoscopic and pathologic correlation

Mark C. Liszewski, V. Anik Sahni, Paul B. Shyn, Sonia Friedman, Jason L. Hornick, Sukru M. Erturk, Koenraad J. Mortele

Research output: Contribution to journalArticle

5 Scopus citations

Abstract

OBJECTIVE: To describe the multidetector-row computed tomography enterographic (MD-CTE) features of the ileal-anal pouch after ileal pouch anal anastomosis (IPAA) surgery and correlate them with pouch endoscopy and histopathologic findings. METHODS: All MD-CTE examinations performed on patients who underwent IPAA from July 1, 2005 to December 1, 2010 (n = 35; 16 [45.7%] men; mean age, 37.7 years; age range, 22-72 years) were retrospectively evaluated in consensus by 2 radiologists. All studies were evaluated for the presence of multiple imaging features. Two radiographic scores were then calculated: a total radiographic score and a radiographic active inflammation score. In patients who underwent MD-CTE, pouch endoscopy, and biopsy within 30 days (n = 13), both scores were correlated with findings on pouch endoscopy and histopathology. RESULTS: Of the 35 patients, 33 (94%) had at least one MD-CTE finding of active or chronic pouch inflammation and 27 patients (77%) had at least one MD-CTE finding of active pouch inflammation. Of the 13 patients who underwent endoscopy and biopsy, the total radiographic score demonstrated a strong positive correlation with endoscopic score (r = 0.81; P = 0.001) and a moderate positive correlation with histopathologic score (r = 0.56; P = 0.047). The radiographic active inflammation score demonstrated a strong positive correlation with endoscopic score (r = 0.83; P = 0.0004), but only a weak nonsignificant positive correlation with histopathologic score (r = 0.492, P = 0.087). CONCLUSIONS: In patients who had IPAA surgery, findings on MD-CTE correlate positively with findings on pouch endoscopy and histopathology and are sensitive measures for pouch inflammation with high positive predictive value. Thus, MD-CTE can be a useful noninvasive test in the early evaluation of symptomatic patients.

Original languageEnglish (US)
Pages (from-to)394-399
Number of pages6
JournalJournal of computer assisted tomography
Volume36
Issue number4
DOIs
StatePublished - Jul 1 2012
Externally publishedYes

Keywords

  • biopsy
  • ileal pouch anal anastomosis
  • multidetector-row CT enterography
  • pouch endoscopy
  • ulcerative colitis

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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