Collagenous sprue cross-sectional imaging: a comparative blinded study

Badr Al-Bawardy, Shannon P. Sheedy, Michelle B. Herberts, Joseph A Murray, Alberto Rubio-Tapia, Elizabeth Rajan, David H. Bruining, Stephanie L. Hansel, John M. Barlow, Joel Garland Fletcher, Jeff L. Fidler

Research output: Contribution to journalArticle

Abstract

Purpose: Collagenous sprue (CS) is a rare enteropathy characterized by villous atrophy and a thickened subepithelial collagen band. The aim of this study is to describe the cross-sectional imaging findings of CS. Methods: A case–control, retrospective study with cases of all CS patients from January 2000 to 2015 was performed. Inclusion criteria were (1) Histopathologic diagnosis and (2) Imaging with computed tomography abdomen/pelvis (CT A/P), CT enterography (CTE), or magnetic resonance enterography within 6 months of small bowel (SB) biopsy. Control subjects were irritable bowel syndrome (IBS) patients who underwent CTE. Imaging studies were examined by two GI radiologists, blinded to patient data. Results: 108 patients (54 CS; 54 IBS) were included. Mean age was 56.7 ± 16.5 years, and 68% were female (72% in CS group vs. 63% in IBS group; p = 0.3). CS patients were significantly older (67 ± 12 vs. 47 ± 15 year; p < 0.001) and more likely to be on angiotensin receptor blockers (41% vs. 6%; p < 0.001) as compared to the IBS group. Compared to IBS, CS patients were more likely to have mesenteric lymph node (LN) prominence (56% vs. 15%; p < 0.001), jejunoileal fold pattern reversal (46% vs. 6%; p < 0.001), SB dilation (28% vs. 0%; p < 0.001), SB conformational change (28% vs. 6%; p = 0.002), SB wall thickening (13% vs. 2%; p = 0.03), and ulcerative jejunoileitis (4% vs. 0%; p = 0.01). Radiologists suspected malabsorption in 72% in the CS group and 2% in the IBS group (p < 0.001). Conclusion: Imaging findings suggestive of mucosal malabsorption are commonly demonstrated in CS.

Original languageEnglish (US)
Pages (from-to)1-7
Number of pages7
JournalAbdominal Radiology
DOIs
StateAccepted/In press - Jan 5 2017

Fingerprint

Collagenous Sprue
Irritable Bowel Syndrome
Angiotensin Receptor Antagonists
Pelvis
Abdomen
Atrophy
Dilatation

Keywords

  • Collagenous sprue
  • CT enterography
  • Enteropathy
  • MR enterography
  • Olmesartan

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology
  • Urology
  • Radiological and Ultrasound Technology

Cite this

Al-Bawardy, B., Sheedy, S. P., Herberts, M. B., Murray, J. A., Rubio-Tapia, A., Rajan, E., ... Fidler, J. L. (Accepted/In press). Collagenous sprue cross-sectional imaging: a comparative blinded study. Abdominal Radiology, 1-7. https://doi.org/10.1007/s00261-016-1007-1

Collagenous sprue cross-sectional imaging : a comparative blinded study. / Al-Bawardy, Badr; Sheedy, Shannon P.; Herberts, Michelle B.; Murray, Joseph A; Rubio-Tapia, Alberto; Rajan, Elizabeth; Bruining, David H.; Hansel, Stephanie L.; Barlow, John M.; Fletcher, Joel Garland; Fidler, Jeff L.

In: Abdominal Radiology, 05.01.2017, p. 1-7.

Research output: Contribution to journalArticle

Al-Bawardy, B, Sheedy, SP, Herberts, MB, Murray, JA, Rubio-Tapia, A, Rajan, E, Bruining, DH, Hansel, SL, Barlow, JM, Fletcher, JG & Fidler, JL 2017, 'Collagenous sprue cross-sectional imaging: a comparative blinded study', Abdominal Radiology, pp. 1-7. https://doi.org/10.1007/s00261-016-1007-1
Al-Bawardy, Badr ; Sheedy, Shannon P. ; Herberts, Michelle B. ; Murray, Joseph A ; Rubio-Tapia, Alberto ; Rajan, Elizabeth ; Bruining, David H. ; Hansel, Stephanie L. ; Barlow, John M. ; Fletcher, Joel Garland ; Fidler, Jeff L. / Collagenous sprue cross-sectional imaging : a comparative blinded study. In: Abdominal Radiology. 2017 ; pp. 1-7.
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abstract = "Purpose: Collagenous sprue (CS) is a rare enteropathy characterized by villous atrophy and a thickened subepithelial collagen band. The aim of this study is to describe the cross-sectional imaging findings of CS. Methods: A case–control, retrospective study with cases of all CS patients from January 2000 to 2015 was performed. Inclusion criteria were (1) Histopathologic diagnosis and (2) Imaging with computed tomography abdomen/pelvis (CT A/P), CT enterography (CTE), or magnetic resonance enterography within 6 months of small bowel (SB) biopsy. Control subjects were irritable bowel syndrome (IBS) patients who underwent CTE. Imaging studies were examined by two GI radiologists, blinded to patient data. Results: 108 patients (54 CS; 54 IBS) were included. Mean age was 56.7 ± 16.5 years, and 68{\%} were female (72{\%} in CS group vs. 63{\%} in IBS group; p = 0.3). CS patients were significantly older (67 ± 12 vs. 47 ± 15 year; p < 0.001) and more likely to be on angiotensin receptor blockers (41{\%} vs. 6{\%}; p < 0.001) as compared to the IBS group. Compared to IBS, CS patients were more likely to have mesenteric lymph node (LN) prominence (56{\%} vs. 15{\%}; p < 0.001), jejunoileal fold pattern reversal (46{\%} vs. 6{\%}; p < 0.001), SB dilation (28{\%} vs. 0{\%}; p < 0.001), SB conformational change (28{\%} vs. 6{\%}; p = 0.002), SB wall thickening (13{\%} vs. 2{\%}; p = 0.03), and ulcerative jejunoileitis (4{\%} vs. 0{\%}; p = 0.01). Radiologists suspected malabsorption in 72{\%} in the CS group and 2{\%} in the IBS group (p < 0.001). Conclusion: Imaging findings suggestive of mucosal malabsorption are commonly demonstrated in CS.",
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author = "Badr Al-Bawardy and Sheedy, {Shannon P.} and Herberts, {Michelle B.} and Murray, {Joseph A} and Alberto Rubio-Tapia and Elizabeth Rajan and Bruining, {David H.} and Hansel, {Stephanie L.} and Barlow, {John M.} and Fletcher, {Joel Garland} and Fidler, {Jeff L.}",
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T2 - a comparative blinded study

AU - Al-Bawardy, Badr

AU - Sheedy, Shannon P.

AU - Herberts, Michelle B.

AU - Murray, Joseph A

AU - Rubio-Tapia, Alberto

AU - Rajan, Elizabeth

AU - Bruining, David H.

AU - Hansel, Stephanie L.

AU - Barlow, John M.

AU - Fletcher, Joel Garland

AU - Fidler, Jeff L.

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N2 - Purpose: Collagenous sprue (CS) is a rare enteropathy characterized by villous atrophy and a thickened subepithelial collagen band. The aim of this study is to describe the cross-sectional imaging findings of CS. Methods: A case–control, retrospective study with cases of all CS patients from January 2000 to 2015 was performed. Inclusion criteria were (1) Histopathologic diagnosis and (2) Imaging with computed tomography abdomen/pelvis (CT A/P), CT enterography (CTE), or magnetic resonance enterography within 6 months of small bowel (SB) biopsy. Control subjects were irritable bowel syndrome (IBS) patients who underwent CTE. Imaging studies were examined by two GI radiologists, blinded to patient data. Results: 108 patients (54 CS; 54 IBS) were included. Mean age was 56.7 ± 16.5 years, and 68% were female (72% in CS group vs. 63% in IBS group; p = 0.3). CS patients were significantly older (67 ± 12 vs. 47 ± 15 year; p < 0.001) and more likely to be on angiotensin receptor blockers (41% vs. 6%; p < 0.001) as compared to the IBS group. Compared to IBS, CS patients were more likely to have mesenteric lymph node (LN) prominence (56% vs. 15%; p < 0.001), jejunoileal fold pattern reversal (46% vs. 6%; p < 0.001), SB dilation (28% vs. 0%; p < 0.001), SB conformational change (28% vs. 6%; p = 0.002), SB wall thickening (13% vs. 2%; p = 0.03), and ulcerative jejunoileitis (4% vs. 0%; p = 0.01). Radiologists suspected malabsorption in 72% in the CS group and 2% in the IBS group (p < 0.001). Conclusion: Imaging findings suggestive of mucosal malabsorption are commonly demonstrated in CS.

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