Role of multidetector computed tomography in patients with acute infectious colitis

BACKGROUND The role of multidetector computed tomography(MDCT) in patients with acute infectious colitis is still unclear.AIM To examine the usefulness of MDCT in distinguishing the etiology of acute infectious colitis.METHODS Overall, 244 patients who met the criteria for acute infectious colitis and visited the Hospital from February 2015 to 2018 were retrospectively enrolled and divided into two groups(bacterial: 204, viral: 40) according to causes of acute colitis, based on stool PCR. Eleven MDCT parameters, including wall thickening, submucosal edema, mucosal enhancement, serosa involvement, empty colon sign, small bowel involvement, comb sign, continuous distribution, accordion sign, mucosal thickening, and lymph node enlargement, were constructed in a blinded fashion.RESULTS MDCT parameters of wall thickening(OR: 13.60; 95%CI: 5.80–31.88; P < 0.001), submucosal edema(OR: 36.08; 95%CI: 13.54–96.13; P < 0.001), mucosal enhancement(OR: 22.55; 95%CI: 9.28–54.81; P < 0.001), serosal involvement(OR: 14.50; 95%CI: 3.33–63.23; P < 0.001), empty colon sign(OR: 6.68; 95%CI:2.44–18.32; P < 0.001), continuous distribution(OR: 24.09; 95%CI: 9.38–61.90; P < 0.001), accordion sign(OR: 9.02; 95%CI: 1.12–72.35; P = 0.038), mucosal thickening(OR: 46.41; 95%CI: 10.38–207.51; P < 0.001), and lymph node enlargement(OR: 4.39; 95%CI: 1.22–15.72; P = 0.023) were significantly associated with bacterial colitis. At least one positive finding in four CT outcomes(submucosal edema, mucosal enhancement, continuous distribution, mucosal thickening) in summer showed a high probability of bacterial colitis(sensitivity, 41.67; specificity, 92.50; OR: 24.95).CONCLUSION MDCT provides many clues that can be useful in suggesting a specific etiology of acute infectious colitis.