Computed tomography enterography for crohn's disease: correlation between the imaging findings and histopathologic scoring system.

Abstract

The aim of this study was to retrospectively determine if quantitative measurements of computed tomography enterography (CTE) imaging findings correlate with histopathologic scores from biopsy specimens in patients with Crohn's disease (CD). CTE datasets of 34 CD patients (19 male and 15 female) who underwent endoscopy with biopsy within 25 days before or after CTE were retrospectively reviewed. CTE findings of segmental mural hyperenhancement, wall thickening, mural stratification and mesenteric findings were quantitatively measured in the corresponding segment. Histopathologic score of CD was based upon the Naini Cortina scoring system. Correlation between CTE findings and histopathologic scores was assessed using Spearman's rank correlation and logistic or linear regression analysis. Neutrophilic inflammation contributed the most to the segmental mural hyperenhancement and explained 38.4% of the variance (R2 = 0.384, P = 0.006). Moreover, the increased lymphocytes and plasma cells predicted larger lymph node (P = 0.003) and increased attenuation in mesenteric fat (P = 0.022). To a certain extent, macroscopic CTE findings may reflect the microscopic histopathologic state in the inflammatory stage of CD, underscoring that establishment of CTE scoring system may potentially provide an objective tool for assessment of disease progression.