Gastrointestinal Wall Thickening in Patients with Hepatic Cirrhosis: MSCT Findings and Clinical Implications_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

CAI Wei ¹ , CHEN Guangwen ¹ , SONG Bin ¹ , YANG Taizhu ²

1.Department of Radiology， West China Hospital, Sichuan University，Chengdu 610041，China;;
2.Department of Ultrasound, West China Second University Hospital, Sichuan University， Chengdu 610041， ChinaCorresponding Author: SONG Bin, E-mail: cjr.songbin@vip.163.com;

Corresponding author：

Keywords：

Bowel wall thickening; Hepatic cirrhosis; Computed tomography/X-ray

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Objective 　To determine the frequencies and patterns of gastrointestinal wall thickening at muti-slice computed tomography (MSCT) in patients with hepatic cirrhosis.
Methods 　One hundred and nine patients with cirrhosis and 130 patients without cirrhosis for gastrointestinal wall thickening were retrospectively analyzed by the abdominal MSCT scans. The frequencies of wall thickening were determined in the cirrhosis patients and in those without cirrhosis. The segmental distribution, symmetry and enhancement pattern were evaluated in all patients with cirrhosis for gastrointestinal wall thickening.
Results 　Gastrointestinal wall thickening was seen in 72 cases (66%) with cirrhosis patients and in 12 cases (9%) without cirrhosis patients (P lt;0.005). The jejunum and ascending colon were the most common sites of gastrointestinal wall thickening, which was involved in 32 and 31 patients respectively. The scans of 46 (64%) patients with gastrointestinal wall thickening showed multisegmental distribution. Gastrointestinal wall thickening was concentric and homogeneous in all patients with cirrhosis.
Conclusion 　Gastrointestinal wall thickening is common in patients with hepatic cirrhosis. It frequently involves multiple segments. The jejunum and ascending colon are the most common sites of involvement. MSCT plays an invaluable role in diagnostic evaluation of bowel wall thickening in patients with hepatic cirrhosis.

Citation： CAI Wei,CHEN Guangwen,SONG Bin,YANG Taizhu. Gastrointestinal Wall Thickening in Patients with Hepatic Cirrhosis: MSCT Findings and Clinical Implications. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2009, 16(4): 329-332. doi: Copy

1.	于红, 李惠民, 刘光华, 等. 肝硬化肝内门-体循环分流的MSCT诊断 [Ｊ]. 中国医学计算机成像杂志, 2004; 10(3): 175-177.
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5.	Karahan OI, Dodd GD 3rd, Chintapalli KN, et al. Gastrointestinal wall thickening in patients with cirrhosis: frequency and patterns at contrast-enhanced CT [Ｊ]. Radiology, 2000; 215(1): 103-107.
6.	Gore RM, Balthazar EJ, Ghahremani GG, et al. CT features of ulcerative colitis and Crohn’s disease [Ｊ]. AJR Am J Roentgenol, 1996; 167(1): 3-15.
7.	James S, Balfe DM, Lee JK, et al. Small-bowel disease: categorization by CT examination [Ｊ]. AJR Am J Roentgenol, 1987; 148(5): 863-868.
8.	吴兴旺. 多层螺旋 CT小肠成像在诊断克隆病中的应用 [Ｊ]. 临床放射学杂志, 2008; 27(10): 1429-1431.
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12.	曹罡, 杨文彬, 黎一鸣, 等. 门静脉动脉化治疗门静脉高压症的实验研究 [Ｊ]. 中国普外基础与临床杂志, 2007; 14(6): 670-674.
13.	Hwang JC, Ha HK, Yoon KH, et al. Colonic wall thickening in cirrhotic patients: CT features and its clinical significance [Ｊ]. Abdom Imaging, 1999; 24(2): 125-128.
14.	Guingrich JA, Kuhlman JE. Colonic wall thickening in patients with cirrhosis: CT findings and clinical implications [Ｊ]. AJR Am J Roentgenol, 1999; 172(4): 919-924.
15.	Kozarek RA, Botoman VA, Bredfeldt JE, et al. Portal colopathy: prospective study of colonoscopy in patients with portal hypertension [Ｊ]. Gastroenterology, 1991; 101(5): 1192-1197.
16.	Madureira AJ. The comb sign [Ｊ]. Radiology, 2004; 230(3): 783-784.
17.	d’Almeida M, Jose J, Oneto J, et al. Bowel wall thickening in children: CT findings [Ｊ]. Radiographics, 2008; 28(3): 727-746.
18.	Ahualli J. The target sign: bowel wall [Ｊ]. Radiology, 2005; 234(2): 549-550.
19.	陈光文，宋彬，吴苾, 等. 肠壁增厚的CT表现及临床意义 [Ｊ]. 中国普外基础与临床杂志, 2008; 15(12): 943-949.
20.	Lane MJ, Katz DS, Mindelzun RE, et al. Spontaneous intramural small bowel haemorrhage: importance of non-contrast CT [Ｊ]. Clin Radiol, 1997; 52(5): 378-380.
21.	Boland GW, Lee MJ, Cats AM, et al. Antibiotic-induced diarrhea: specificity of abdominal CT for the diagnosis of Clostridium difficile disease [Ｊ]. Radiology, 1994; 191(1): 103-106.
22.	吴玉芬, 史秀珍, 刘桂英, 等. 肝硬化患者结肠壁增厚的CT特征及其临床意义 [Ｊ]. 肿瘤防治杂志, 2003; 10(11): 1229.

1. 于红, 李惠民, 刘光华, 等. 肝硬化肝内门-体循环分流的MSCT诊断 [Ｊ]. 中国医学计算机成像杂志, 2004; 10(3): 175-177.
2. Marshak RH, Khilnani M, Eliasoph J, et al. Intestinal edema [Ｊ]. Am J Roentgenol Radium Ther Nucl Med, 1967; 101(2): 379-398.
3. Balthazar EJ, Gade MF. Gastrointestinal edema in cirrhotics. Radiographic manifestations and pathogenesis with emphasis on colonic involvement [Ｊ]. Gastrointest Radiol, 1976; 1(3): 215-223.
4. 王锡明, 武乐斌, 李振家, 等. 多层螺旋CT在大肠分区及肠壁厚度测量中的价值 [Ｊ]. 医学影像学杂志, 2005; 15(2): 144-146.
5. Karahan OI, Dodd GD 3rd, Chintapalli KN, et al. Gastrointestinal wall thickening in patients with cirrhosis: frequency and patterns at contrast-enhanced CT [Ｊ]. Radiology, 2000; 215(1): 103-107.
6. Gore RM, Balthazar EJ, Ghahremani GG, et al. CT features of ulcerative colitis and Crohn’s disease [Ｊ]. AJR Am J Roentgenol, 1996; 167(1): 3-15.
7. James S, Balfe DM, Lee JK, et al. Small-bowel disease: categorization by CT examination [Ｊ]. AJR Am J Roentgenol, 1987; 148(5): 863-868.
8. 吴兴旺. 多层螺旋 CT小肠成像在诊断克隆病中的应用 [Ｊ]. 临床放射学杂志, 2008; 27(10): 1429-1431.
9. 林均海, 包小娜. CT在肠壁增厚性疾病中的诊断价值 [Ｊ]. 实用放射学杂志, 2003; 19(6): 559-561.
10. 杜菁. 77例肝硬变腹部增强CT出现胃肠壁增厚49例临床分析 [Ｊ]. 沈阳医学院学报, 2006; 8(2): 111-113.
11. 汤光宇, 吴访宏, 王骐, 等. 肝硬化结肠壁增厚的CT表现及其临床意义 [Ｊ]. 临床放射学杂志, 2001; 20(7): 514-516.
12. 曹罡, 杨文彬, 黎一鸣, 等. 门静脉动脉化治疗门静脉高压症的实验研究 [Ｊ]. 中国普外基础与临床杂志, 2007; 14(6): 670-674.
13. Hwang JC, Ha HK, Yoon KH, et al. Colonic wall thickening in cirrhotic patients: CT features and its clinical significance [Ｊ]. Abdom Imaging, 1999; 24(2): 125-128.
14. Guingrich JA, Kuhlman JE. Colonic wall thickening in patients with cirrhosis: CT findings and clinical implications [Ｊ]. AJR Am J Roentgenol, 1999; 172(4): 919-924.
15. Kozarek RA, Botoman VA, Bredfeldt JE, et al. Portal colopathy: prospective study of colonoscopy in patients with portal hypertension [Ｊ]. Gastroenterology, 1991; 101(5): 1192-1197.
16. Madureira AJ. The comb sign [Ｊ]. Radiology, 2004; 230(3): 783-784.
17. d’Almeida M, Jose J, Oneto J, et al. Bowel wall thickening in children: CT findings [Ｊ]. Radiographics, 2008; 28(3): 727-746.
18. Ahualli J. The target sign: bowel wall [Ｊ]. Radiology, 2005; 234(2): 549-550.
19. 陈光文，宋彬，吴苾, 等. 肠壁增厚的CT表现及临床意义 [Ｊ]. 中国普外基础与临床杂志, 2008; 15(12): 943-949.
20. Lane MJ, Katz DS, Mindelzun RE, et al. Spontaneous intramural small bowel haemorrhage: importance of non-contrast CT [Ｊ]. Clin Radiol, 1997; 52(5): 378-380.
21. Boland GW, Lee MJ, Cats AM, et al. Antibiotic-induced diarrhea: specificity of abdominal CT for the diagnosis of Clostridium difficile disease [Ｊ]. Radiology, 1994; 191(1): 103-106.
22. 吴玉芬, 史秀珍, 刘桂英, 等. 肝硬化患者结肠壁增厚的CT特征及其临床意义 [Ｊ]. 肿瘤防治杂志, 2003; 10(11): 1229.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Gastrointestinal Wall Thickening in Patients with Hepatic Cirrhosis: MSCT Findings and Clinical Implications

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