Computed Tomography Enterography: Quantitative Evaluation on Crohn’s Disease Activity

Hao Yang,Jingyun Cheng,Guobin Xu,Ke Wang,Hui Xie,Guangyao Wu

doi:10.1155/2018/7351936

Hao Yang, Jingyun Cheng + Show 4 more

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https://doi.org/10.1155/2018/7351936

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Abstract

Objective To explore the feasibility of computed tomography enterography (CTE) in the quantitative evaluation of the activity of Crohn's disease (CD). Methods There were 49 CD patients with whole clinical, enteroscopy, and CTE data to be analyzed retrospectively. The patients were graded as inactive (0–2), mild (3–6), and moderate-severe group (>6) based on simplified endoscopic activity score for Crohn's disease (SES-CD). The differences in bowel wall thickening, mural hyperenhancement in the portal vein period, and the ΔCT values were analyzed among groups using ANOVA (analysis of variance) and q test. Then, the parameters were correlated with SES-CD, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR). Results In the 49 patients, 13 ones were inactive, 19 ones were mild, and 17 ones were moderate-severe; the thickness of bowel wall, mural hyperenhancement in the portal vein period, and ΔCT value among groups were all significantly different (P < 0.001 in all). Correlative analysis showed that compared with the SES-CD, the bowel wall thickening (r = 0.564, P < 0.001), mural hyperenhancement in the portal vein period (r = 0.585, P < 0.001), and ΔCT value (r = 0.533, P < 0.001) were moderately correlated. Conclusion The mural hyperenhancement in the portal vein period, bowel wall thickening, and ΔCT value can accurately and quantitatively assess the activity of CD lesions and are potential visual biomarkers of CD lesions.

Highlights

Crohn’s disease (CD) is an idiopathic, chronic, relapsing, transmural inflammatory disease that affects the entire gastrointestinal tract and has a tendency toward segmental distribution [1, 2]
Our study showed that bowel wall thickening, mural hyperenhancement, and the ΔCT value were moderately correlated with simplified endoscopic activity score for CD (SES-CD), which was in line with the results of some studies about computed tomography enterography (CTE) [4, 8] and magnetic resonance enterography (MRE) [9, 10]
Wu et al [4] found that bowel wall thickening and mural hyperenhancement were significantly correlated with CD lesion activity

Summary

Introduction

CD is an idiopathic, chronic, relapsing, transmural inflammatory disease that affects the entire gastrointestinal tract and has a tendency toward segmental distribution [1, 2]. Clinical endoscopy is the gold standard for diagnosing and assessing CD activity [3]; its aggressive nature and risks associated with complications limit its long-term follow-up in the application of CD patients. CTE is widely used in clinical practice It can reveal intestinal lesions, assess intestinal inflammation, and clearly show extraintestinal complications, such as internal fistula, abdominal abscess, mesenteric hypervascularity, cellulitis, and lymph nodes [4,5,6]. Few studies have made a quantitative assessment and grading lesion activity based on CTE imaging findings in CD patients; patients with different levels of activity have different treatment regimens. This study was designed to investigate the feasibility and application of CTE in quantitatively assessing and grading CD activity based on the simplified endoscopic activity score for CD (SES-CD)

Methods

Discussion

Conclusion