The value of Clermont score in detection intestinal mucosal ulcer of Crohn's disease

Abstract

Objective: To explore the value of Clermont score in the detection of intestinal mucosal ulcer in Crohn's disease (CD). Methods: From May 2015 to August 2017, 45 patients (28 males and 17 females; median age was 25 years) were confirmed to have ileocolic CD by endoscopic and pathological examinations at Nanjing General Hospital. All patients underwent MRE and DWI examinations. Based on the appearance of intestinal mucosa endoscopically, intestine segments from 45 patients were divided into three groups, namely, no ulceration group (NU), superficial ulceration group (SU), and deep ulceration group (DU). Several factors contribute to Clermont score calculation. These included the measurement of intestinal wall thickness using MRE, evaluation of intestinal wall edema and ulceration by MRE, DWI performance and ADC value of each segment. One-way ANOVA was utilized to compare the Clermont scores and ADC values of the intestine segments among the three groups. The efficacy of the Clermont scores and ADC values in evaluating intestinal mucosal ulcer in CD was verified using ROC analysis. Results: A total of 137 intestine segments were included in the study with 30 cases in NU, 37 cases in SU, and 70 cases in DU.DU had the highest Clermont score (22.5±4.5),following were SU(15.8±3.5) and NU(10.2±1.3)(F=179.935,P<0.01).The ADC values of DU ((1.34±0.17)×10(-3)mm(2)/s) was lower than NU ((2.07±0.52)×10(-3)mm(2)/s) and SU ((1.52±0.23)×10(-3) mm(2)/s) (F=83.822,P<0.01).The AUCs of using Clermont score and ADC value in differentiating deep ulcerations were 0.887 and 0.733, respectively. Conclusions: Either Clermont score or ADC value can be used to evaluate mucosal ulcer in CD. Clermont score demonstrates a better efficacy than ADC value in detecting deep ulcerations.