Wu Ying-Wei, Tao Xiao-Feng, Tang Yong-Hua, Hao Nan-Xin, Miao Fei
Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University, School of Medicine, China.
Abdom Imaging. 2012 Jun;37(3):350-8. doi: 10.1007/s00261-011-9808-8.
To determine retrospectively if quantitative measures of the comb sign at CT enterography correlated with laboratory indications in Crohn's disease. We retrospectively included 72 known CD patients (47 male and 25 female patients) and 41 normal controls who had undergone CT enterography (CTE) from 2008 to 2010 and had high-sensitive C reaction protein (Hs-CRP) and erythrocyte sedimentation rate (ESR) results. We divided the 72 CD patients into two groups based on disease activity which was determined by Rutgeerts' score. 41 patients were characterized as active disease while 31 patients were as inactive disease. For each individual, one reformatted coronal CTE image in which the comb sign (vasa recta) was most obviously displayed was selected by two experienced radiologists in a double blind manner. For each image, 20 regions of interest (ROI) with area of 1 cm(2) were drawn and placed over the site where the comb sign exists; the comb sign amount was counted in each ROI and recorded. Total amount of the comb sign were assessed from 20 ROI data. Quantitative comb sign results were compared with Hs-CRP and ESR level. Quantitative comb sign score is significantly higher in the CD group than in the control group at both the arterial stage and venous stage (P < 0.001). Quantitative comb sign score is obviously higher in active CD patients than in inactive CD patients both at arterial stage and venous stage (3.63 vs. 2.86 at arterial stage; 3.53 vs. 2.90 at venous stage). ESR level was well correlated with quantitative comb sign score both at arterial and venous stage whereas Hs-CRP has no significant correlation at either stage. Quantitative comb sign results did well in predicting CD activity with the accuracy rate of 78.4% at arterial stage and 80% at venous stage when using 3.33 as the cutoff of quantitative comb sign score. Quantitative comb sign score is a promising CTE parameter in predicting CD activity and be well correlates with the ESR level.
回顾性确定CT小肠造影中梳征的定量指标与克罗恩病实验室指标之间是否存在相关性。我们回顾性纳入了2008年至2010年间接受过CT小肠造影（CTE）且有高敏C反应蛋白（Hs-CRP）和红细胞沉降率（ESR）结果的72例已知克罗恩病患者（47例男性和25例女性患者）以及41例正常对照者。我们根据由 Rutgeerts评分确定的疾病活动度将72例克罗恩病患者分为两组。41例患者为活动期疾病，31例患者为非活动期疾病。对于每个个体，由两名经验丰富的放射科医生以双盲方式选择一张冠状位CTE重组图像，其中梳征（直小血管）显示最明显。对于每张图像，在梳征存在的部位绘制20个面积为1平方厘米的感兴趣区域（ROI）；计算每个ROI中的梳征数量并记录。从20个ROI数据评估梳征的总量。将梳征的定量结果与Hs-CRP和ESR水平进行比较。在动脉期和静脉期，克罗恩病组的梳征定量评分均显著高于对照组（P<0.001）。在动脉期和静脉期，活动期克罗恩病患者的梳征定量评分均明显高于非活动期克罗恩病患者（动脉期为3.63对2.86；静脉期为3.53对2.90）。在动脉期和静脉期，ESR水平与梳征定量评分均具有良好的相关性，而Hs-CRP在任一阶段均无显著相关性。当以3.33作为梳征定量评分的临界值时，梳征定量结果在预测克罗恩病活动度方面表现良好，动脉期准确率为78.4%，静脉期准确率为80%。梳征定量评分是预测克罗恩病活动度的一个有前景的CTE参数，且与ESR水平具有良好的相关性。
