Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi 755-8505, Japan.
Gastroenterol Res Pract. 2013;2013:984916. doi: 10.1155/2013/984916. Epub 2013 Apr 27.
Aim. When determining therapeutic strategy, it is important to diagnose small intestinal lesions in Crohn's disease (CD) precisely and to evaluate mucosal healing as well as clinical remission in CD. The purpose of this study was to compare findings from computed tomographic enteroclysis/enterography (CTE) with those from the mucosal surface and to determine whether the state of mucosal healing can be determined by CTE. Materials and Methods. Of the patients who underwent CTE for CD, 39 patients were examined whose mucosal findings could be confirmed by colonoscopy, capsule endoscopy, balloon endoscopy, or with the resected surgical specimens. Results. According to the CTE findings, patients were determined to be in the active CD group (n = 31) or inactive CD group (n = 8). The proportion of previous surgery, clinical remission, stenosis, and CDAI score all showed significant difference between groups. Mucosal findings showed an association with ulcer in 93.6% of active group patients but in only 12.5% of inactive group patients (P < 0.0001), whereas mucosal healing was found in 62.5% of inactive group patients but in only 3.2% of active group patients (P < 0.0001). Conclusion. CTE appeared to be a useful diagnostic method for assessment of mucosal healing in Crohn's disease.
在确定治疗策略时,重要的是要准确诊断克罗恩病(CD)的小肠病变,并评估 CD 的黏膜愈合和临床缓解情况。本研究的目的是比较 CT 肠造影/肠成像(CTE)与黏膜表面的结果,并确定 CTE 是否可以确定黏膜愈合的状态。
对接受 CTE 检查的 CD 患者中,有 39 例患者的黏膜发现可以通过结肠镜检查、胶囊内镜检查、气囊内镜检查或切除的手术标本得到证实。
根据 CTE 检查结果,将患者分为活动期 CD 组(n = 31)和非活动期 CD 组(n = 8)。手术史、临床缓解、狭窄和 CDAI 评分的比例在两组间均有显著差异。黏膜表现与活动期组 93.6%的患者的溃疡有关,但与非活动期组 12.5%的患者无关(P < 0.0001),而非活动期组 62.5%的患者存在黏膜愈合,但活动期组仅 3.2%的患者存在黏膜愈合(P < 0.0001)。
CTE 似乎是评估克罗恩病黏膜愈合的一种有用的诊断方法。