Content area
Full text
Correspondence to Dr Subashini Chandrapalan, Department of Gastroenterology, County Durham and Darlington Foundation Trust, Durham DL3 6HX, UK; [email protected]
Introduction
CT scanning is a widely used imaging modality in the diagnostic work-up of bowel pathologies. Recent advances in CT scanning, such as the multidetector technology, allow higher accuracy and sensitivity in the diagnosis of abdominal pathologies.1 One of the findings on abdominopelvic CT imaging is that of colonic mural thickening (MT). Colonic MT may be a reflection of inflammatory, infective, ischaemic and neoplastic pathologies.2 On the other hand, MT may simply be due to benign strictures or collapsed segments of the colon.
In the setting of colonic MT, patients may have to undergo colonoscopy for further evaluation. However, currently there are no definitive guidelines as to when colonoscopic examination is needed. This often results in a diagnostic dilemma, especially when the clinical index of suspicion is low.
Several studies have evaluated the clinical significance of MT on CT imaging and its correlation with subsequent colonoscopic findings. Few studies have, however, illustrated the differentiating features of benign from malignant MT. In this study, we have conducted a systematic review of MT on abdominal CT imaging and its correlation with colonoscopic findings, to provide a more precise and reliable evidence for the clinical significance of MT identified on abdominal CT.
Materials and methods
The aim of this systematic review was to evaluate the significance of colonic MT on CT and its correlation with pathologies identified by colonoscopy performed within a 4-week period. In accordance with the guidelines, our systematic review has been registered with the International Prospective Register of Systematic Reviews (PROSPERO) and is reported according to the recommendations from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2015 statement.
Study selection and eligibility criteria
We included studies which (1) were prospective and retrospective comparative cohort studies, case-controlled studies, nested case–control studies, and cross-sectional studies; (2) examined general adult human population of 18 years or older, both healthy subjects and those with colonic pathologies; (3) examined subjects who have had colonoscopic evaluation following a CT scan: studies which described non-colonic MT, that is, sites other than from the ileocaecal valve to the rectosigmoid junction, were excluded; and (4) were published in English and were...