Multi-detector row CT: spectrum of diseases involving the ileocecal area

Abstract

The ileocecal area is a relatively short segment of the gastrointestinal tract but may be affected by pathologic conditions that are either common throughout the gastrointestinal system or exclusive to this area. These conditions include benign and malignant tumors, inflammatory processes (appendicitis, diverticulitis, epiploic appendagitis, Crohn disease), infectious diseases, and miscellaneous conditions (cecal ischemia, typhlitis, cecal volvulus, duplication cyst). The various components of the ileocecal area (cecum, appendix, ileocecal valve, terminal ileum) are close to one another, so that these conditions may involve more than one anatomic structure, thereby creating a diagnostic dilemma. The evaluation of various parameters (eg, stratified enhancement pattern of the thickened bowel wall, degree of thickening, extent and location of bowel wall involvement, degree of fat stranding relative to the degree of wall thickening) and associated findings (lymph nodes, mesenteric stranding, abscess and sinus tracts, fatty proliferation, solid organ abnormalities) will help narrow the differential diagnosis. Multi-detector row computed tomography (CT) is considered the best imaging examination for the evaluation of the ileocecal area. Consequently, the radiologist should be familiar with the multi-detector row CT features of the spectrum of diseases affecting this area to help ensure correct diagnosis and appropriate treatment.