Colonic wall redundancy at CT in patients with cystic fibrosis

Emily M. Webb, Mary Ellen Kleinhenz, Fergus Coakley, Ching I Belinda Chang, Antonio C. Westphalen, Benjamin M. Yeh

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Purpose: To describe the appearance, prevalence, and possible associations of colonic wall redundancy in patients with cystic fibrosis (CF). Materials and Methods: The institutional review board approved this HIPAA-compliant study. Abdominal computed tomographic (CT) images of 38 consecutive patients with CF and a control group of 38 consecutive potential renal donors were retrospectively identified. Three readers independently recorded presence and location of colonic wall redundancy and wall thickness of the ascending, transverse, and descending colon. Interobserver agreement for colonic wall redundancy was determined with the κ statistic. Colonic wall thicknesses were compared between patient groups with the Student t test. Proportions of adult and pediatric patients with and those without colonic wall redundancy and prevalence of specific gene mutations were compared between groups with the Fisher exact test. CT findings were compared with radiologic reports and clinical records. Results: Each reviewer found colonic wall redundancy in 11 of 28 adults with CF but in none of the children with CF (P <.05 for each reviewer). There was excellent interobserver agreement for identification of colonic wall redundancy (κ = 0.91, P <.001). Mean thickness of the wall of the ascending colon was significantly greater in patients with CF who had colonic wall redundancy (4.0 mm) than in those without this finding (1.8 mm, P <.05) or in control patients (1.2 mm, P <.05). Among adult patients with CF, ΔF508 mutation was the predominant mutant allele in 10 of 13 patients with normal colons at CT, whereas more uncommon non-ΔF508 mutations were seen in seven of 10 patients with colonic wall redundancy (P <.05). Asymptomatic colonic wall redundancy at CT was prospectively misinterpreted as acute colonic disease in five adult patients. Conclusion: Proximal colonic wall redundancy is seen frequently in adults with CF and may be more common in those with non-ΔF508 CFTR gene mutations. This finding provides a starting point for further investigation of the molecular basis of colonic phenotype in CF.

Original languageEnglish (US)
Pages (from-to)869-875
Number of pages7
JournalRadiology
Volume248
Issue number3
DOIs
StatePublished - Sep 2008
Externally publishedYes

Fingerprint

Cystic Fibrosis
Ascending Colon
Mutation
Colonic Diseases
Health Insurance Portability and Accountability Act
Descending Colon
Transverse Colon
Research Ethics Committees
Acute Disease
Genes
Colon
Alleles
Tissue Donors
Pediatrics
Students
Phenotype
Kidney
Control Groups

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Webb, E. M., Kleinhenz, M. E., Coakley, F., Chang, C. I. B., Westphalen, A. C., & Yeh, B. M. (2008). Colonic wall redundancy at CT in patients with cystic fibrosis. Radiology, 248(3), 869-875. https://doi.org/10.1148/radiol.2482071457

Colonic wall redundancy at CT in patients with cystic fibrosis. / Webb, Emily M.; Kleinhenz, Mary Ellen; Coakley, Fergus; Chang, Ching I Belinda; Westphalen, Antonio C.; Yeh, Benjamin M.

In: Radiology, Vol. 248, No. 3, 09.2008, p. 869-875.

Research output: Contribution to journalArticle

Webb, EM, Kleinhenz, ME, Coakley, F, Chang, CIB, Westphalen, AC & Yeh, BM 2008, 'Colonic wall redundancy at CT in patients with cystic fibrosis', Radiology, vol. 248, no. 3, pp. 869-875. https://doi.org/10.1148/radiol.2482071457
Webb EM, Kleinhenz ME, Coakley F, Chang CIB, Westphalen AC, Yeh BM. Colonic wall redundancy at CT in patients with cystic fibrosis. Radiology. 2008 Sep;248(3):869-875. https://doi.org/10.1148/radiol.2482071457
Webb, Emily M. ; Kleinhenz, Mary Ellen ; Coakley, Fergus ; Chang, Ching I Belinda ; Westphalen, Antonio C. ; Yeh, Benjamin M. / Colonic wall redundancy at CT in patients with cystic fibrosis. In: Radiology. 2008 ; Vol. 248, No. 3. pp. 869-875.
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abstract = "Purpose: To describe the appearance, prevalence, and possible associations of colonic wall redundancy in patients with cystic fibrosis (CF). Materials and Methods: The institutional review board approved this HIPAA-compliant study. Abdominal computed tomographic (CT) images of 38 consecutive patients with CF and a control group of 38 consecutive potential renal donors were retrospectively identified. Three readers independently recorded presence and location of colonic wall redundancy and wall thickness of the ascending, transverse, and descending colon. Interobserver agreement for colonic wall redundancy was determined with the κ statistic. Colonic wall thicknesses were compared between patient groups with the Student t test. Proportions of adult and pediatric patients with and those without colonic wall redundancy and prevalence of specific gene mutations were compared between groups with the Fisher exact test. CT findings were compared with radiologic reports and clinical records. Results: Each reviewer found colonic wall redundancy in 11 of 28 adults with CF but in none of the children with CF (P <.05 for each reviewer). There was excellent interobserver agreement for identification of colonic wall redundancy (κ = 0.91, P <.001). Mean thickness of the wall of the ascending colon was significantly greater in patients with CF who had colonic wall redundancy (4.0 mm) than in those without this finding (1.8 mm, P <.05) or in control patients (1.2 mm, P <.05). Among adult patients with CF, ΔF508 mutation was the predominant mutant allele in 10 of 13 patients with normal colons at CT, whereas more uncommon non-ΔF508 mutations were seen in seven of 10 patients with colonic wall redundancy (P <.05). Asymptomatic colonic wall redundancy at CT was prospectively misinterpreted as acute colonic disease in five adult patients. Conclusion: Proximal colonic wall redundancy is seen frequently in adults with CF and may be more common in those with non-ΔF508 CFTR gene mutations. This finding provides a starting point for further investigation of the molecular basis of colonic phenotype in CF.",
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