Colombel J F, Solem C A, Sandborn W J, Booya F, Loftus E V, Harmsen W S, Zinsmeister A R, Bodily K D, Fletcher J G
Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA.
Gut. 2006 Nov;55(11):1561-7. doi: 10.1136/gut.2005.084301. Epub 2006 Apr 28.
Few studies have correlated computed tomography (CT) enterography findings with endoscopic severity and C reactive protein (CRP) concentrations.
To examine whether small bowel inflammation at CT enterography correlates with endoscopic severity and CRP in patients with Crohn's disease (CD).
CT enterography datasets from 143 CD patients undergoing ileoscopy were examined for three different CT parameters: CT bowel enhancement, as defined by the ratio of terminal ileal versus control ileal loop attenuation; vascular enlargement of the vasa recta ("the comb sign"); and mesenteric fat density. Correlations between CT scan parameters, endoscopy, and histology severity scores, and CRP were assessed using Spearman's rank correlation and logistic regression.
Endoscopic score was significantly correlated with CT bowel enhancement, comb sign, and fat density (Spearman correlation coefficients 0.33-0.39; p<0.001). Correlations with histological inflammation were strongest for bowel enhancement (r = 0.34-0.38; p<0.001). CRP was elevated in patients with increased fat density versus those with increased bowel enhancement only (median 0.96 v 0.23, p = 0.002). CRP did not differ significantly between patients without evidence of active Crohn's and those with bowel enhancement and endoscopic inflammation not involving the perienteric tissues by CT (median 0.24 v 0.36; p = 0.38).
Quantitative measures of bowel enhancement at CT enterography correlate with endoscopic and histological severity. CRP correlates with radiological findings of perienteric inflammation (increased fat density), but not of inflammation limited to the small bowel wall, underscoring the potential role of perienteric inflammation in CRP response in CD.
很少有研究将计算机断层扫描（CT）小肠造影结果与内镜严重程度及C反应蛋白（CRP）浓度相关联。
探讨克罗恩病（CD）患者CT小肠造影时的小肠炎症是否与内镜严重程度及CRP相关。
对143例行回肠镜检查的CD患者的CT小肠造影数据集进行检查，观察三个不同的CT参数：CT肠强化，由终末回肠与对照回肠袢衰减比值定义；直小血管增粗（“梳征”）；以及肠系膜脂肪密度。使用Spearman秩相关和逻辑回归评估CT扫描参数、内镜检查、组织学严重程度评分及CRP之间的相关性。
内镜评分与CT肠强化、梳征及脂肪密度显著相关（Spearman相关系数为0.33 - 0.39；p<0.001）。肠强化与组织学炎症的相关性最强（r = 0.34 - 0.38；p<0.001）。脂肪密度增加的患者与仅肠强化增加的患者相比，CRP升高（中位数0.96对0.23，p = 0.002）。无活动性克罗恩病证据的患者与CT显示肠强化及内镜炎症但不累及肠周组织的患者之间，CRP无显著差异（中位数0.24对0.36；p = 0.38）。
CT小肠造影时肠强化的定量测量与内镜及组织学严重程度相关。CRP与肠周炎症的影像学表现（脂肪密度增加）相关，但与局限于小肠壁的炎症无关，这突出了肠周炎症在CD患者CRP反应中的潜在作用。
