Diagnostic Role of Computed Tomographic Enterography Differentiating Crohn Disease From Intestinal Tuberculosis

Abstract

OBJECTIVES: The aim of the present study was to evaluate the diagnostic role of computed tomographic enterography (CTE) in distinguishing Crohn disease (CD) from intestinal tuberculosis (ITB). MATERIALS AND METHODS: From January 2006 to August 2011, a total of 81 consecutive patients (64 patients with CD and 17 patients with ITB) who received CTE on the initial workup were included. In CTE, degree of bowel involvement (number and length), mural change (mural hyperenhancement, stratification, wall thickening, and distribution), adjacent mesenteric change (comb sign, fibrofatty proliferation, fistula, abscess, and lymphadenopathy), and peritoneal change (peritoneal thickening and ascites) were assessed. RESULTS: Segmental involvement, comb sign, fibrofatty changes, moderate wall thickening, and asymmetric distribution were significantly more common in the patients with CD than those with ITB. A positive comb sign was the most suggestive finding of CD (sensitivity, 74.1%; specificity, 90.9%). CONCLUSIONS: A positive comb sign is the most suggestive finding that differentiates CD from ITB.