Bowel wall thickening on computed tomography scan: Inter-observer agreement and correlation with endoscopic findings.

Autor: Daniel F; Department of Internal Medicine, Gastroenterology Division, American University of Beirut, Riad El Solh, Beirut 1107 2020, Lebanon. Electronic address: fd21@aub.edu.lb., Alsheikh M; Department of Internal Medicine, Gastroenterology Division, American University of Beirut, Riad El Solh, Beirut 1107 2020, Lebanon., Ghieh D; Department of Diagnostic Radiology, American University of Beirut, Riad El Solh, Beirut 1107 2020, Lebanon. Electronic address: dmg03@mail.aub.edu., Hosni M; Department of Internal Medicine, Gastroenterology Division, American University of Beirut, Riad El Solh, Beirut 1107 2020, Lebanon. Electronic address: mh268@aub.edu.lb., Tayara Z; Department of Diagnostic Radiology, American University of Beirut, Riad El Solh, Beirut 1107 2020, Lebanon., Tamim H; Biostatisitics Unit, American University of Beirut, Riad El Solh, Beirut 1107 2020, Lebanon. Electronic address: htamim@aub.edu.lb., Abi-Ghanem AS; Department of Diagnostic Radiology, American University of Beirut, Riad El Solh, Beirut 1107 2020, Lebanon. Electronic address: aa277@aub.edu.lb., El-Merhi F; Department of Diagnostic Radiology, American University of Beirut, Riad El Solh, Beirut 1107 2020, Lebanon; Department of Imaging, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA; Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA. Electronic address: fe19@aub.edu.lb.
Jazyk: angličtina
Zdroj: Arab journal of gastroenterology : the official publication of the Pan-Arab Association of Gastroenterology [Arab J Gastroenterol] 2020 Dec; Vol. 21 (4), pp. 219-223. Date of Electronic Publication: 2020 Jul 08.
DOI: 10.1016/j.ajg.2020.04.012
Abstrakt: Background and Study Aims: Bowel wall thickening (BWT) on computed tomography (CT) has been frequently reported by radiologists. There are no clear guidelines regarding the level of thickening that is correlated with definite pathology. Radiologists usually rely on their overall subjective impression, and studies on inter-observer agreement (IOA) are lacking. This study evaluated IOA concerning BWT found on abdominal CT and identified the corresponding findings on endoscopy.
Patients and Methods: Reports of abdominal CTs performed between January 2000 and December 2015 containing the term 'thickening' were retrieved from the radiology department database. Corresponding patients who later underwent endoscopy were included. IOA concerning BWT was evaluated using a randomly mixed sample of 80 patients with normal findings or pathological BWT on endoscopy. A search for predictive factors for the subsequent finding of malignancy on endoscopy was performed using multivariate analysis.
Results: During the study period, 6142 CT scans described thickening, equivalent to a BWT prevalence of 13.7%. Ninety-one patients (mean age, 58 years) were included in the analysis. Thickening was found most commonly in the stomach (38.5%), followed by the rectum (22%) and small intestine (14%). Twenty-seven patients (29.7%) exhibited diffuse BWT, whereas 64 patients showed localised BWT (70.3%). Biopsy was performed for 64 of 91 patients with endoscopies. Among these patients, 8.8% exhibited normal findings, whereas inflammation and malignancy were discovered in 25 and 51.6% of patients, respectively, with a positive predictive value for malignancy of 0.36. The IOA concerning CT for predicting significantly pathological BWT was moderate (mean κ = 0.6). A strong association was evident between the presence of lymph nodes on CT and the presence of neoplastic lesions.
Conclusion: Our study strongly recommends endoscopic follow-up of patients exhibiting BWT irrespective of the thickening location, especially if it is associated with lymphadenopathy. IOA between radiologists was moderate.
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2020. Published by Elsevier B.V.)
Databáze: MEDLINE
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