Spectrum of bowel wall thickening on computed tomography (CT) and its interpretation; a prospective study

Abstract

Introduction:Computed tomography (CT) study of patients with bowel pathologies may show bowel wall thickening with abnormal morphology and enhancement. Identification of these patterns may help better differentiate benign lesions from malignant lesions.Aim:To study and identify various CT enhancement patterns and other characteristics of thickened bowel wall and their usefulness in categorising bowel wall thickening as benign or malignant. Materials and methods: The study was a prospective study in which a total of 50 cases were studied by over a period of approximately 1 year by performing contrast CT scans using MDCT scanner. Based on certain CT findings and CT patterns, the bowel wall thickening were categorised as benign and malignant and probable diagnosis were given. Cases were followed up for final diagnosis and compared with the CT diagnosis. Relevant statistical analysis was done to assess the role of CT features & enhancement patterns, in differentiating benign and malignant disease processes. Results: Combination of asymmetric, marked, focal and heterogeneous patterns to categorise a lesion as malignant showed high specificity (94.1%). Overall CT characteristics and enhancement patterns has shown high sensitivity (96.9%) and high specificity (88.2%) in differentiating bowel wall thickening as malignant or benign. Conclusion: Contrast CT study is highly sensitive & specific for diagnosing a lesion as malignant or benign, especially when certain imaging features and enhancement patterns of thickening bowel wall are actively looked for.