Correlations Between Colonic Wall Thickening in Patients with Virally Induced Cirrhosis on CT and Clinical Status

ObjectivesLumacaftor-ivacaftor is a cystic fibrosis transmembrane conductance regulator (CFTR) modulator known to improve clinical status in people with cystic fibrosis (CF). This study aimed to assess lung structural changes after one year of lumacaftor-ivacaftor treatment, and to use unsupervised machine learning to identify morphological phenotypes of lung disease that are associated with response to lumacaftor-ivacaftor.MethodsAdolescents and adults with CF from the French multicenter real-world prospective observational study evaluating the first year of treatment with lumacaftor-ivacaftor were included if they had pretherapeutic and follow-up chest computed tomography (CT)-scans available. CT scans were visually scored using a modified Bhalla score. A k-mean clustering method was performed based on 120 radiomics features extracted from unenhanced pretherapeutic chest CT scans.ResultsA total of 283 patients were included. The Bhalla score significantly decreased after 1 year of lumacaftor-ivacaftor (−1.40±1.53 points compared with pretherapeutic CT; p<0.001). This finding was related to a significant decrease in mucus plugging (−0.35±0.62 points; p<0.001), bronchial wall thickening (−0.24±0.52 points; p<0.001) and parenchymal consolidations (−0.23±0.51 points; p<0.001). Cluster analysis identified 3 morphological clusters. Patients from cluster C were more likely to experience an increase in percent predicted forced expiratory volume in 1 sec (ppFEV1) ≥5 under lumacaftor–ivacaftor than those in the other clusters (54% of responders versus 32% and 33%; p=0.01).ConclusionOne year treatment with lumacaftor-ivacaftor was associated with a significant visual improvement of bronchial disease on chest CT. Radiomics features on pretherapeutic CT scan may help in predicting lung function response under lumacaftor-ivacaftor.

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Exclusive Phlebosclerosis of Submucosal Veins Leading to Ischemic Necrosis and Perforation of the Large Bowel: First European Case

Case Reports in Gastroenterology ◽

10.1159/000488195 ◽

2018 ◽

Vol 12 (1) ◽

pp. 137-142 ◽

Cited By ~ 1

Author(s):

Sebastian Klein ◽

Denise Buchner ◽

De-hua Chang ◽

Reinhard Büttner ◽

Uta Drebber ◽

...

Keyword(s):

Wall Thickening ◽

Caucasian Woman ◽

Ischemic Necrosis ◽

Colonic Wall ◽

Asian Patients ◽

Life Threatening ◽

History Of ◽

Mesenteric Vessels ◽

The Right ◽

European Woman

Phlebosclerotic colitis (PC) is a rare, potentially life-threatening disease of unclear pathogenesis almost exclusively reported in Asian patients of both genders. A fibrous degeneration of venous walls leads to threadlike calcifications along mesenteric vessels and colonic wall thickening, detectable by CT. This causes disturbed blood drainage and hemorrhagic infarction of the right-sided colonic wall. This is a report of PC in a Caucasian woman in Europe without Asian background and no history of herbal medications, a suspected cause in Asian patients. CT revealed no calcification of the mesenteric vein or its tributaries. Instead, submucosal veins of the left-sided colonic wall were calcified, leading to subsequent transmural necrosis. Clinically, the patient developed a paralytic ileus and sigmoidal perforation during a 2-week hospitalization due to a bleeding cerebral vascular aneurysm. This case of a European woman with PC is unique in its course as well as its radiologic, clinical, and pathologic presentation.

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Colonic Wall Thickening Reported in Abdominal CT: Does It Always Imply Malignancy?

Gastroenterology Research and Practice ◽

10.1155/2019/2492097 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

A. Akbas ◽

H. Bakir ◽

M. F. Dasiran ◽

H. Dagmura ◽

E. Daldal ◽

...

Keyword(s):

Colon Cancer ◽

Univariate Analysis ◽

Wall Thickening ◽

Abdominal Ct ◽

Colonic Wall ◽

Colon Wall ◽

Neutrophil Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Independent Variables ◽

Ct Examination

Aim/Background. Early diagnosis of patients with colon cancer is one of the most important parameters affecting the survival of patients. In this study, we aimed to examine the effect of the age, hemoglobin (Hb), albumin, neutrophil lymphocyte ratio (NLR), thrombocyte lymphocyte ratio (PLR), and mean platelet values (MPV) on the separation of benign and malignant diseases in patients with suspected colon wall thickness (CWT) observed in abdominal computed tomography (CT) examination. Method. The study included 116 patients between the ages of 18 and 95 who had CT examination where the colon wall could be evaluated and who also had colonoscopy. Patients suspected for CWT in CT with difficulties in differential diagnosis were divided into two groups according to colonoscopic-histopathological evaluations. Normal or benign pathological causes were included in the first group, while malignant causes constituted the second group. Whether the two groups differed in terms of CWT, Hb, age, albumin, NLR, PLR, and MPV values was investigated with descriptive statistics. Results. One hundred and sixteen patients (74 males, 42 females) with CT examinations and colonoscopic sampling were included in the study. After colonoscopic and histopathological evaluations, there were 64 cases in the first group and 52 in the second group. According to the results of the univariate analysis and multivariate logistic regression, CWT, Hb, NLR, and MPV were identified to be independent variables for determining colon cancer. Conclusion. A combined evaluation of Hb, NLR, and MPV values in patients with CWT in abdominal CT examination may contribute to the separation of benign and malignant pathologies.

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Unusual Causes of Colonic Wall Thickening on Computed Tomography

Clinical Radiology ◽

10.1016/s0009-9260(02)00468-3 ◽

2003 ◽

Vol 58 (3) ◽

pp. 191-200 ◽

Cited By ~ 7

Author(s):

D.R Turner ◽

G Markose ◽

M.J Arends ◽

C.S Ng ◽

A.H Freeman

Keyword(s):

Computed Tomography ◽

Wall Thickening ◽

Colonic Wall

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Colonic wall thickening in patients with cirrhosis: CT findings and clinical implications.

American Journal of Roentgenology ◽

10.2214/ajr.172.4.10587121 ◽

1999 ◽

Vol 172 (4) ◽

pp. 919-924 ◽

Cited By ~ 22

Author(s):

J A Guingrich ◽

J E Kuhlman

Keyword(s):

Wall Thickening ◽

Clinical Implications ◽

Colonic Wall ◽

Ct Findings

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Fulminant Shigellosis in a HIV Patient

Case Reports in Infectious Diseases ◽

10.1155/2015/128104 ◽

2015 ◽

Vol 2015 ◽

pp. 1-3

Author(s):

Siang Mei Sally Ooi

Keyword(s):

Rare Case ◽

Wall Thickening ◽

Immunosuppressed Patient ◽

Hartmann Procedure ◽

Pneumatosis Coli ◽

Colonic Wall ◽

Intravenous Antibiotics ◽

Infectious Enterocolitis

Infectious enterocolitis caused byshigellais usually self-limiting and seldom requires antibiotics treatment. It is uncommon to develop fulminant shigellosis requiring surgery. We report a rare case of fulminant shigellosis in a HIV patient with recurring infection which could not be managed with intravenous antibiotics. CT reviewed extensive colonic wall thickening and stranding with evidence of pneumatosis coli. The patient eventually required a Hartmann procedure. Although fulminant shigellosis is uncommon, thorough assessment and vigilant management are warranted in immunosuppressed patient.

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