Role of multidetector computed tomography in patients with acute infectious colitis

Table 1 Acute colitis prevalence and summary statistics of baseline characteristics by COI

	Value	Total	Viral	Bacterial	P value1
Prevalence (%)			16	84
Season (%)	Spring	24	35	22	0.001
	Summer	39	15	44
	Autumn	22	23	22
	Winter	15	28	13
Sex (%)	Male	45	45	45	1.000
DM (%)	Yes	14	15	13	0.801
CVD (%)	Yes	11	10	11	1.000
MALIG (%)	Yes	3	3	3	1.000
Age (mean ± SD)		45.1 ± 20.9	41.8 ± 21.5	45.7 ± 20.8	0.271
Height (mean ± SD)		165.4 ± 9.6	166.5 ± 9.4	165.2 ± 9.6	0.487
Weight (mean ± SD)		65.1 ± 14.6	67.8 ± 17.4	64.6 ± 14.1	0.271
BMI (mean ± SD)		23.7 ± 4.1	24.1 ± 4.6	23.6 ± 4.1	0.492

¹Fisher's exact test for season, sex, diabetes mellitus, cardiovascular disease;, and history of malignancy, and ANOVA test otherwise.

DM: Diabetes mellitus; CVD: Cardiovascular disease; MALIG: History of malignancy; BMI: Body mass index.

Table 2 Acute colitis prevalence for 11 computed tomography parameters by COI

	Value	Total	Viral	Bacterial	P value1
Prevalence (%)			16	84
Wall thickening (%)2	Yes	82	40	90	0.000
Submucosal edema (%)	Yes	82	30	93	0.000
Mucosal enhancement (%)	Yes	79	28	89	0.000
Serosal involvement (%)	Yes	39	5	46	0.000
Empty colon sign (%)2	Yes	43	13	49	0.000
Small bowel involvement (%)	Yes	38	30	40	0.288
Comb sign (%)	Yes	13	3	15	0.036
Continuous distribution (%)	Yes	75	25	85	0.000
Accordion sign (%)	Yes	15	3	17	0.014
Mucosal thickening (%)	Yes	57	5	67	0.000
Lymph node enlargement (%)	Yes	18	8	21	0.072

¹Fisher's exact test.

²Recategorized to binary values of normal vs non-normal.

Table 3 Sensitivity and specificity of the 11 computed tomography parameters for predicting viral or bacterial acute colitis prevalence

CT parameter	Viral				Bacterial
	Se (%)	Sp (%)	PPV (%)	NPV (%)	Se (%)	Sp (%)	PPV (%)	NPV (%)
Wall thickening1	40.0	10.3	8.0	46.7	89.7	60.0	92.0	53.3
Submucosal edema	30.0	7.4	6.0	34.9	92.6	70.0	94.0	65.1
Mucosal enhancement	27.5	11.3	5.7	44.2	88.7	72.5	94.3	55.8
Serosal involvement	5.0	53.9	2.1	74.3	46.1	95.0	97.9	25.7
Empty colon sign1	12.5	51.0	4.8	74.8	49.0	87.5	95.2	25.2
Small bowel involvement	30.0	60.3	12.9	81.5	39.7	70.0	87.1	18.5
Comb sign	2.5	85.3	3.2	81.7	14.7	97.5	96.8	18.3
Continuous distribution	25.0	15.2	5.5	50.8	84.8	75.0	94.5	49.2
Accordion sign	2.5	82.8	2.8	81.3	17.2	97.5	97.2	18.8
Mucosal thickening	5.0	33.3	1.4	64.2	66.7	95.0	98.6	35.8
Lymph node enlargement	7.5	79.4	6.7	81.4	20.6	92.5	93.3	18.6

¹Recategorized to binary values of normal vs non-normal.

CT: Computed tomography; Se: Sensitivity; Sp: Specificity; PPV: Positive predictive value; NPV: Negative predictive value.

Table 4 Odds ratios of viral or bacterial acute colitis prevalence for each of the 11 computed tomography parameters

CT parameter	Viral				Bacterial
	OR	95%CI		P value	OR	95%CI		P value
Wall thickening1	0.07	0.03	0.17	0.000	13.60	5.80	31.88	0.000
Submucosal edema	0.03	0.01	0.07	0.000	36.08	13.54	96.13	0.000
Mucosal enhancement	0.04	0.02	0.11	0.000	22.55	9.28	54.81	0.000
Serosal involvement	0.07	0.02	0.30	0.000	14.50	3.33	63.23	0.000
Empty colon sign1	0.15	0.05	0.41	0.000	6.68	2.44	18.32	0.000
Small bowel involvement	0.69	0.32	1.50	0.353	1.44	0.67	3.13	0.353
Comb sign	0.19	0.02	1.50	0.115	5.25	0.67	41.32	0.115
Continuous distribution	0.04	0.02	0.11	0.000	24.09	9.38	61.90	0.000
Accordion sign	0.11	0.01	0.89	0.038	9.02	1.12	72.35	0.038
Mucosal thickening	0.02	0.00	0.10	0.000	46.41	10.38	207.51	0.000
Lymph node enlargement	0.23	0.06	0.82	0.023	4.39	1.22	15.72	0.023

¹Recategorized to binary values of normal vs non-normal.

Adjusted for age, season, sex, diabetes, cardiovascular diseases, and cancer history. CT: Computed tomography.

Table 5 Sensitivity and specificity of the four combined computed tomography parameters¹ for predicting viral or bacterial acute colitis prevalence

CT parameter	Viral				Bacterial
	Se (%)	Sp (%)	PPV (%)	NPV (%)	Se (%)	Sp (%)	PPV (%)	NPV (%)
Summer and all four	2.50	74.02	1.85	79.47	25.98	97.50	98.15	20.53
Summer and at least one	7.50	58.33	3.41	76.28	41.67	92.50	96.59	23.72
Winter and all four	2.50	90.69	5.00	82.59	9.31	97.50	95.00	17.41
Winter and at least one	15.00	87.75	19.35	84.04	12.25	85.00	80.65	15.96

¹Submucosal edema, mucosal enhancement, continuous distribution, and mucosal thickening.

CT: Computed tomography; Se: Sensitivity; Sp: Specificity; PPV: Positive predictive value; NPV: Negative predictive value.

Table 6 Odds ratios of viral or bacterial acute colitis prevalence for each of the four combined computed tomography parameters¹

CT parameter	Viral				Bacterial
	OR	95%CI		P value	OR	95%CI		P value
Summer and all four	0.13	0.01	1.16	0.07	7.75	0.86	69.93	0.07
Summer and at least one	0.04	0.01	0.28	0.00	24.95	3.59	173.43	0.00
Winter and all four	0.04	0.00	0.35	0.00	26.90	2.82	256.26	0.00
Winter and at least one	0.04	0.00	0.40	0.01	28.51	2.48	327.72	0.01

¹Submucosal edema, mucosal enhancement, continuous distribution, mucosal thickening. Adjusted for age, season, sex, diabetes, cardiovascular diseases, and cancer history.

CT: Computed tomography.