Xue Song Zhao MD, Presenter: Nothing to Disclose

fei miao, Abstract Co-Author: Nothing to Disclose

Fuhua Yan, Abstract Co-Author: Nothing to Disclose

Xianfu Luo, Abstract Co-Author: Nothing to Disclose

Xiao Zhu Lin MD, Abstract Co-Author: Nothing to Disclose

To investigate the value of CT enterography in the diagnosis of phlebosclerotic colitis with endoscopic and histopathologic findings as a reference standard

 The institutional review board approved the study protocol and informed consent was obtained from all patients. Features from CT enterography in 6 patients with endoscopically and histopathologically confirmed phlebosclerotic colitis were retrospectively reviewed. CT enterography was performed on the Discovery CT750 HD scanner (GE Healthcare, Waukesha, Wisconsin, USA )

 Phlebosclerotic colitis at CT enterography showed the same features: multiple tortuous threadlike calcifications along the course of the colon perpendicular to the colonic wall. Coronary reconstructed CT enterographic images in portal venous phase clearly disclosed patchy or threadlike calcifications corresponding to the calcified walls of the branches of right and middle colic veins and their intramural tributaries. The thickened colon wall manifested stratified pattern (the trilaminar appearance). There were no skip lesions. Swelling of the ileocecal valve, disappearance of semi-lunar folds, luminal irregularities, rigidity of the colon and increased adjacent hazy density in the surrounding fatty tissue were also observed. Endoscopic images showed that the mucosa lost its normal vascular network and had a dark-purple, hyperemic and edematous appearance with multiple superficial ulcers and erosions. Blue-black vessels were visible and the wall of the ascending colon was particularly friable.  

Phlebosclerotic colitis had its unique CT entrographic and endosopic features. CT enterography with multiplanar reformatting of axial image data provides better visualization of the entire small bowel wall and allows detection of extra-luminal as well as the mesenteric vessel diseases

Phlebosclerotic colitis has its specific CT enterographic features, radiologists should be familiar with this rare type of ischemic colitis caused by obstruction of the veins in the intestinal wall and adjacent mesentery, and is most commonly seen in the ascending colon.

Zhao, X, miao, f, Yan, F, Luo, X, Lin, X, Value of CT Enterography in the Diagnosis of Phlebosclerotic Colitis.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14007128.html