Background: Mural thickening (MT) on computed tomography (CT) poses a diagnostic dilemma in the absence of clear reporting guidelines. The aim of this study was to analyse CT reports, identifying patients in whom gastrointestinal wall MT was observed, and to correlate these reports with subsequent endoscopic evaluation. Methods: Patients with MT who had follow-up endoscopy were included in the study (n = 308). The cohort was subdivided into upper gastrointestinal mural thickening (UGIMT) amp; lower gastrointestinal mural thickening (LGIMT). Results: In total, 55.71% (n = 122) of colonoscopies and 61.8% (n = 55) of gastroscopies were found to be normal. Haemoglobin (HB) level in combination with MT was a predictor of neoplasia in both arms (p = 0.04 UGIMT cohort, p #x3c; 0.001 LGIMT cohort). In addition to this, age was a significant correlative parameter in both UGIMT and LGIMT cohorts (p = 0.003, p #x3c; 0.001 respectively). Dysphagia and weight loss were associated with UGI malignancies (38 and 63% respectively) and rectal bleeding was correlative in 20% of patients with LGI malignancies. Conclusion: HB, advancing age, and red flag symptoms are potentially useful adjuncts to MT in predicting upper and lower gastrointestinal malignancies. We propose the adoption of a streamlined pathway to delineate patients who should undergo endoscopic investigation following CT identification of MT.
Dig Surg

中文翻译：

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使用临床参数作为内窥镜评估常规计算机断层扫描诊断恶性肿瘤中的壁增厚的辅助手段

背景：在缺乏明确的报告指南的情况下，计算机断层扫描 (CT) 上的壁增厚 (MT) 造成诊断困境。本研究的目的是分析 CT 报告，确定观察到胃肠壁 MT 的患者，并将这些报告与随后的内窥镜评估相关联。方法：接受内窥镜检查的 MT 患者被纳入研究（ n = 308）。该队列被细分为上消化道壁增厚 (UGIMT) 和；下消化道壁增厚 (LGIMT)。结果：总共有 55.71% ( n = 122) 的结肠镜检查和 61.8% ( n= 55) 的胃镜检查是正常的。血红蛋白 (HB) 水平与 MT 相结合是双臂肿瘤形成的预测因子（p = 0.04 UGIMT 队列，p #x3c；0.001 LGIMT 队列）。除此之外，年龄在 UGIMT 和 LGIMT 队列中都是一个重要的相关参数（分别为p = 0.003，p #x3c；0.001）。吞咽困难和体重减轻与 UGI 恶性肿瘤相关（分别为 38% 和 63%），直肠出血与 20% 的 LGI 恶性肿瘤患者相关。结论：HB、年龄增长和红旗症状是 MT 预测上消化道和下消化道恶性肿瘤的潜在有用辅助手段。我们建议采用简化的途径来描述在 CT 识别出 MT 后应该接受内窥镜检查的患者。
挖掘外科