Author/Authors :
Park Eun Kyung نويسنده Department of Radiology, Korea University College of
Medicine, Seoul, Korea , Kim Min Ju نويسنده Department of Radiology, Korea University Anam Hospital,
Korea University College of Medicine, Seoul, South
Korea , Han Na Yeon نويسنده Department of Radiology, Korea University Anam Hospital,
Korea University College of Medicine, Seoul, Republic of
Korea , Park Beom Jin نويسنده Department of Radiology, Korea University Anam Hospital,
Korea University College of Medicine, Seoul, Republic of
Korea , Sung Deuk Jae نويسنده Department of Radiology, Korea University Anam Hospital,
Korea University College of Medicine, Seoul, Republic of
Korea , Cho Sung Beom نويسنده Department of Radiology, Korea University Anam Hospital,
Korea University College of Medicine, Seoul, Republic of
Korea , Jeen Yoon Tae نويسنده Department of Internal Medicine, Division of
Gastroenterology and Hepatology, Korea University Anam Hospital,
Korea University College of Medicine, Seoul, Republic of
Korea , Keum Bora نويسنده Department of Internal Medicine, Division of
Gastroenterology and Hepatology, Korea University Anam Hospital,
Korea University College of Medicine, Seoul, Republic of
Korea
Abstract :
Background The accurate evaluation of Crohn’s disease activity is
important for the treatment of the disease and for monitoring the
response. Computerized tomography (CT) enterography is a useful imaging
modality that reflects enteric inflammation, as well as extramural
complications. Objectives The aim of this study was to evaluate the
correlation between CT enterographic (CTE) findings of active Crohn’s
disease and the Crohn’s disease activity index (CDAI) and C-reactive
protein (CRP). Patients and Methods Fifty CT enterographies of 39
patients with Crohn’s disease in the small bowel were used in our study.
The CDAI was assessed through clinical and laboratory variables.
Multiple CT parameters, including mural hyperenhancement, mural
thickness, mural stratification, comb sign, and mesenteric fat
attenuation, were evaluated with a four-point scale. The presence or
absence of enhanced lymph nodes, fibrofatty proliferation, sinus or
fistula, abscess, and stricture were also assessed. Two gastrointestinal
radiologists independently reviewed all CT images, and inter-observer
agreement was examined. Correlations between CT findings, CRP, and CDAI
were assessed using Spearman’s rank correlation and logistic regression
analysis. To assess the predictive accuracy of the model, a
receiver-operating characteristic curve analysis for the sum of CT
enterographic scores was used. Results Mural hyperenhancement, mural
thickness, comb sign, mesenteric fat density, and fibrofatty
proliferation were significantly correlated with CDAI and CRP (P
< 0.05). The binary logistic regression model demonstrated that
mesenteric fat density, mural stratification, and the presence of
enhanced lymph nodes (P < 0.05) had an influence on CDAI
severity. The area under the receiver operating characteristic curve
(AUROC) of the CTE index for predicting disease activity was 0.85. Using
a cut-off value of 8, the sensitivity and negative predictive values
were 95% and 94%, respectively. Conclusion Most CTE findings correlated
with CDAI and CRP in patients with active Crohn’s disease.
