Objective:To investigate the clinical and imaging features of colonic Crohn′s disease (CD) and ulcerative colitis (UC) .Methods:A retrospective analysis was performed on 40 patients with colonic CD and 40 patients with UC who admitted to The Sixth Affiliated Hospital of Sun Yat-sen University from January 2013 to July 2020. All the patients underwent CT enterography examination and had complete clinical data. The differences of clinical and CT features between the two groups were compared. The characteristics ( P<0.05) were incorporated into the binary logistic regression model, and the predictors of diagnosing colonic CD were screened. Results:There were significant differences in age of onset (29.3 ± 10.7 vs. 46.6 ± 13.4, P<0.001) , body mass index [ (18.4 ± 2.7) kg/m 2 vs. (21.0 ± 4.0) kg/m 2, P=0.001] and ratio of bloody stool symptom (47.5% vs. 90.0%, P<0.001) between colonic CD group and UC group. Ascending colon involvement was more common in colonic CD than that in UC (70.0% vs. 20.0%, P<0.001) . Continuous distribution of lesions (80.0% vs. 57.5%, P = 0.03) and circumferential uniform thickening of intestinal wall (77.5% vs. 47.5%, P = 0.006) were more common in UC patients, peri-intestinal fat inflammation (20.0% vs. 67.5%, P<0.001) and anal fistula (10.0% vs. 57.5%, P<0.001) were less common in UC patients. It was more likely that the severity of different parts was inconsistent (75.0% vs. 45.0%, P = 0.006) , and the thickness of intestinal wall was thicker [ (9.5 ± 3.4) mm vs. (8.1 ± 2.2) mm, P = 0.024] in patients with colonic CD as compared to patients with UC. Multivariate regression models showed that involvement of ascending colon ( OR = 9.209, 95% CI: 2.238 to 37.902, P = 0.002) , peri-intestinal fat inflammation ( OR = 9.861, 95% CI: 2.384 to 40.786, P = 0.002) and anal fistula ( OR = 19.263, 95% CI: 3.714 to 99.905, P<0.001) are independent predictors for diagnosis of colonic CD. Conclusions:Combining with CT features and clinical manifestations, colonic CD and UC can be effectively distinguished, which provides an important reference value for further clinical treatment decision.

Objective:To investigate the clinical and imaging features of colonic Crohn′s disease (CD) and ulcerative colitis (UC) .Methods:A retrospective analysis was performed on 40 patients with colonic CD and 40 patients with UC who admitted to The Sixth Affiliated Hospital of Sun Yat-sen University from January 2013 to July 2020. All the patients underwent CT enterography examination and had complete clinical data. The differences of clinical and CT features between the two groups were compared. The characteristics ( P<0.05) were incorporated into the binary logistic regression model, and the predictors of diagnosing colonic CD were screened. Results:There were significant differences in age of onset (29.3 ± 10.7 vs. 46.6 ± 13.4, P<0.001) , body mass index [ (18.4 ± 2.7) kg/m 2 vs. (21.0 ± 4.0) kg/m 2, P=0.001] and ratio of bloody stool symptom (47.5% vs. 90.0%, P<0.001) between colonic CD group and UC group. Ascending colon involvement was more common in colonic CD than that in UC (70.0% vs. 20.0%, P<0.001) . Continuous distribution of lesions (80.0% vs. 57.5%, P = 0.03) and circumferential uniform thickening of intestinal wall (77.5% vs. 47.5%, P = 0.006) were more common in UC patients, peri-intestinal fat inflammation (20.0% vs. 67.5%, P<0.001) and anal fistula (10.0% vs. 57.5%, P<0.001) were less common in UC patients. It was more likely that the severity of different parts was inconsistent (75.0% vs. 45.0%, P = 0.006) , and the thickness of intestinal wall was thicker [ (9.5 ± 3.4) mm vs. (8.1 ± 2.2) mm, P = 0.024] in patients with colonic CD as compared to patients with UC. Multivariate regression models showed that involvement of ascending colon ( OR = 9.209, 95% CI: 2.238 to 37.902, P = 0.002) , peri-intestinal fat inflammation ( OR = 9.861, 95% CI: 2.384 to 40.786, P = 0.002) and anal fistula ( OR = 19.263, 95% CI: 3.714 to 99.905, P<0.001) are independent predictors for diagnosis of colonic CD. Conclusions:Combining with CT features and clinical manifestations, colonic CD and UC can be effectively distinguished, which provides an important reference value for further clinical treatment decision.

OBJECTIVETo demonstrate the clinical applicability of three-dimensional CT angiography by evaluating the anatomic features and variation of inferior mesenteric artery(IMA) and left colic artery(LCA) in order to provide reference to vessel ligation strategy in laparoscopic rectal cancer surgery.

METHODSClinical and image data of 123 patients receiving abdominal multislice CT at The Sixth Affiliated Hospital from 2014 to 2015 were retrospectively analyzed. The images were 3D-reconstructed with computer 3D CT angiography and arterial enhancement phase images were chosen for analysis. Linear distances from IMA root to abdominal aortic bifurcation and from LCA at IMA root level to IMA root were measured. Branch types of IMA, coursing pattern of LCA, and association between LCA and inferior mesenteric vein (IMV) site were summarized.

RESULTSOf 123 cases, 80 were males and 43 were females, mean age was (46.8±16.6) years, body weight was (57.7±10.4) kg, and BMI was (21.3±3.6) kg/m. The average distance from IMA root to abdominal aortic bifurcation was (42.5±7.9) mm, and this distance was closely associated with body weight (OR=4.771, 95%CI: 1.398 to 16.283, P=0.013). Longer distance tended to appear in the heavier patients. LCA and sigmoid artery (SA) originating from same single IMA was found in 61(49.6%) cases; LCA and SA forking at same point in 35(28.5%) cases; LCA and SA coursing together and forking afterwards in 24(19.5%) cases, and LCA disappearing in 3(2.4%) cases. In 71(57.7%) patients, LCA ascended medial to the lateral border of left kidney, while in 16(13.0%) patients, LCA arranged below the inferior border of left kidney. When the LCA site was higher and the distance from LCA to IMA root was closer [distance from LCA to IMA root level was (24.2±9.9) mm, (30.0±15.2) mm and (66.6±12.3) mm, F=83.2, P<0.001]. At the level of IMA root, LCA located medial to IMV in 21(17.1%) cases, located just lateral to IMV in 54(43.9%) cases, and located lateral and ascended far away from IMV in 48(39.0%) cases.

CONCLUSION3D-CT angiography is non-invasive, efficient and accurate in evaluating coursing features and variation of IMA and its branches, which can provide important reference to the surgeons, promising laparoscopic surgery smooth and safe.