CT of Prominent Pericolic or Perienteric Vasculature in Patients with Crohn's Disease: Correlation with Clinical Disease Activity and Findings on Barium Studies
Seung Soo Lee1,
Hyun Kwon Ha1,
Suk-Kyun Yang2,
Ah Young Kim1,
Tae Kyoung Kim1,
Pyo Nyun Kim1,
Moon-Gyu Lee1,
Seung-Jae Myung2,
Hwoon-Yong Jung2,
Jin Ho Kim2 and
Young II Min2
1 Department of Radiology, Asan Medical Center, University of Ulsan College of
Medicine, 388-1 Poongnap-dong, Songpa-gu, Seoul, 138-736, Korea.
2 Department of Gastroenterology, Asan Medical Center, University of Ulsan
College of Medicine, Songpa-gu, Seoul, 138-736, Korea.
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Fig. 1A. —15-year-old girl with Crohn's disease involving small bowel
and colon. Contrast-enhanced CT scan shows concentric wall thickening
(open arrows) of jejunum. Perienteric vasculature of diseased jejunum
is dilated and tortuous and has comblike arrangement (solid arrows).
Involvement of ascending colon (C) is seen as concentric wall thickening.
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Fig. 1B. —15-year-old girl with Crohn's disease involving small bowel
and colon. Image from small-bowel follow-through study obtained 3 days after
A shows longitudinal and perpendicular ulcerations (arrows) in
jejunum.
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Fig. 1C. —15-year-old girl with Crohn's disease involving small bowel
and colon. Follow-up CT scan obtained 20 months after A shows some
improvement in bowel wall thickening (open arrow) in jejunum.
Slightly decreased prominence of perienteric vasculature (solid
arrows) in regional mesentery that covers jejunum and invades pericolonic
space is evident. C = ascending colon.
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Fig. 2A. —23-year-old man with Crohn's disease involving small bowel.
Contrast-enhanced CT scan reveals bowel wall thickening (open arrow)
of distal ileum. Note prominent vasa recta (solid arrows) in involved
ileum.
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Fig. 2B. —23-year-old man with Crohn's disease involving small bowel.
Image from small-bowel follow-through study obtained 8 days before A
shows longitudinal and perpendicular ulcerations (arrows) in distal
ileum.
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Fig. 3A. —49-year-old woman with Crohn's disease involving small bowel.
Five years before these imaging studies were obtained, patient had undergone
segmental resection of ileum because of protein-losing enteropathy.
Contrast-enhanced CT scan shows bowel wall thickening (arrows) in
ileum, but prominent perienteric vasculature of involved ileum is not revealed
on CT.
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Fig. 3B. —49-year-old woman with Crohn's disease involving small bowel.
Five years before these imaging studies were obtained, patient had undergone
segmental resection of ileum because of protein-losing enteropathy. Spot
compression image of small-bowel follow-through study obtained 1 day after
A shows linear ulcer (arrows) in mesenteric border and
pseudosacculation (arrowheads) along antimesenteric border.
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Fig. 4A. —43-year-old woman with Crohn's disease involving colon.
Contrast-enhanced CT scans show bowel wall thickening (open arrows)
of colon with loss of haustration. Note markedly prominent pericolic
vasculature (solid arrows) highlighted by fibrofatty proliferation.
Prominent pericolic vasculature is more clearly visualized in A, and
bowel wall thickening is well depicted in B.
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Fig. 4B. —43-year-old woman with Crohn's disease involving colon.
Contrast-enhanced CT scans show bowel wall thickening (open arrows)
of colon with loss of haustration. Note markedly prominent pericolic
vasculature (solid arrows) highlighted by fibrofatty proliferation.
Prominent pericolic vasculature is more clearly visualized in A, and
bowel wall thickening is well depicted in B.
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Fig. 4C. —43-year-old woman with Crohn's disease involving colon. Image
from double-contrast barium enema obtained 7 days before A and B
shows longitudinal and perpendicular ulcerations (arrows) in
transverse colon.
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Fig. 5A. —18-year-old woman with Crohn's disease involving colon.
Contrast-enhanced CT scan shows bowel wall thickening (open arrow) of
ascending colon. Prominent pericolic vasculature (solid arrow) of
ascending colon is apparent when compared with uninvolved transverse colon
(T). Lymphadenopathy (arrowheads) is seen in paraaortic area as well
as in mesentery.
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Fig. 5B. —18-year-old woman with Crohn's disease involving colon. Image
from double-contrast barium enema obtained 2 days after A reveals
longitudinal and perpendicular ulcerations (arrows) in right
colon.
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Fig. 6A. —30-year-old man with Crohn's disease involving colon.
Contrast-enhanced CT scan shows mild bowel wall thickening (arrow) of
sigmoid colon. Other findings, such as prominent pericolic vasculature of
involved colonic segment or pericolic infiltration, are not seen.
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Fig. 6B. —30-year-old man with Crohn's disease involving colon. Image
from double-contrast barium enema reveals aphthoid lesions
(arrowheads) in sigmoid colon.
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Copyright © 2002 by the American Roentgen Ray Society.
