Clinical Significance of Bowel Wall Thickening Detected with 64-Slice Multidetector Computed Tomography

Abstract

The multidetector computed tomography (MDCT) scanning frequently leads to the incidental discovery of bowel wall thickening. The aim of this study was to determine the utility of gastroscopy and colonoscopy in the management of patients who had incidental discovery of bowel wall thickening on MDCT. From May 2006 to March 2008, the abdominal MDCT reports of all patients in Chungbuk National University Hospital were reviewed. Cases with any bowel thickening were selected and then patients who received gastroscopy or colonoscopy after abdominal MDCT were re-selected. Gastroscopy revealed abnormal findings in 22 (95.7%) out of 23 patients, and 10 patients (43.5%) had stomach cancers. Colonoscopy revealed abnormal findings in 35 (85.4%) out of 41 patients, and 12 patients (29%) had malignant tumors. In the patients who had lymph node enlargement (p<0.001), dirty fat infiltration (p=0.025), and irregular wall thickening (p<0.001) on MDCT malignancy was observed more frequently. We recommend gastroscopy and colonoscopy to patients who had incidentally bowel wall thickening found on MDCT, especially those with lymph node enlargement, dirty fat infiltration, and irregular wall thickening.