Chest High-resolution Computed Tomography Findings in 601 Patients with Inflammatory Bowel Diseases

Acad Radiol. 2018 Apr;25(4):407-414. doi: 10.1016/j.acra.2017.10.010. Epub 2017 Nov 28.

Abstract

Rationale and objectives: Pulmonary involvement in inflammatory bowel disease may reflect the common embryonic origin of the gastrointestinal tract and the bronchial tree. No studies have compared pulmonary high-resolution computed tomography (HRCT) findings between ulcerative colitis (UC) and Crohn disease (CD). This study aimed to assess the relationship between pulmonary HRCT findings and inflammatory bowel disease activity and to compare HRCT findings between UC and CD.

Materials and methods: We retrospectively identified 601 consecutive patients (350 with UC and 251 with CD) who had undergone chest HRCT examinations at our institutions between April 2004 and April 2016. Parenchymal abnormalities, enlarged lymph nodes, and pleural effusion were evaluated on HRCT.

Results: One hundred sixty-seven patients (94 men, 73 women; aged 12-86 years, mean: 47.2 years) with UC and 93 patients (61 men, 32 women; aged 12-71 years, mean: 37.9 years) with CD had abnormal findings on chest HRCT. The HRCT findings of UC and CD mainly consisted of centrilobular nodules (in 49.1% and 45.2% of cases, respectively) and bronchial wall thickening (in 31.7% and 54.8%, respectively). There was no relationship between HRCT findings and disease activity. Bronchial wall thickening was significantly more frequent in patients with CD than in those with UC (P < .001).

Conclusion: The main chest HRCT findings in UC and CD are centrilobular nodules and bronchial wall thickening. There are differences in HRCT findings between UC and CD.

Keywords: Crohn disease; High-resolution computed tomography; chest; inflammatory bowel disease; ulcerative colitis.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Bronchi / diagnostic imaging*
  • Bronchi / pathology
  • Child
  • Colitis, Ulcerative / complications*
  • Crohn Disease / complications*
  • Female
  • Humans
  • Lymphadenopathy / complications
  • Lymphadenopathy / diagnostic imaging
  • Male
  • Middle Aged
  • Pleural Effusion / complications
  • Pleural Effusion / diagnostic imaging
  • Retrospective Studies
  • Solitary Pulmonary Nodule / complications
  • Solitary Pulmonary Nodule / diagnostic imaging*
  • Tomography, X-Ray Computed / methods*
  • Young Adult