Ye Y X, Ju S S, Huang W, Lin W W
School of Medicine, Southeast University, Nanjing 210009, China.
Department of Medical Imaging, Nanjing General Hospital, Nanjing 210002, China.
Zhonghua Yi Xue Za Zhi. 2019 Aug 6;99(29):2293-2296. doi: 10.3760/cma.j.issn.0376-2491.2019.29.009.
To explore the value of Clermont score in the detection of intestinal mucosal ulcer in Crohn's disease (CD). 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. 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. 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)(179.935,0.01).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) (83.822,0.01).The AUCs of using Clermont score and ADC value in differentiating deep ulcerations were 0.887 and 0.733, respectively. 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.
探讨克莱蒙评分在克罗恩病（CD）肠黏膜溃疡检测中的价值。2015年5月至2017年8月，南京总医院经内镜及病理检查确诊为回结肠型CD的患者45例（男28例，女17例；中位年龄25岁）。所有患者均接受了磁共振肠造影（MRE）和扩散加权成像（DWI）检查。根据内镜下肠黏膜表现，将45例患者的肠段分为三组，即无溃疡组（NU）、浅表溃疡组（SU）和深部溃疡组（DU）。计算克莱蒙评分的因素有多个。包括使用MRE测量肠壁厚度、通过MRE评估肠壁水肿和溃疡情况、各肠段的DWI表现及表观扩散系数（ADC）值。用于比较三组肠段的克莱蒙评分和ADC值。采用受试者工作特征（ROC）分析验证克莱蒙评分和ADC值在评估CD肠黏膜溃疡中的效能。本研究共纳入137个肠段，其中NU组30例肠段，SU组37例肠段，DU组70例肠段。DU组的克莱蒙评分最高（22.5±4.5），其次是SU组（15.8±3.5）和NU组（10.2±1.3）（179.935，P<0.01）。DU组的ADC值（（1.34±0.17）×10⁻³mm²/s）低于NU组（（2.07±0.52）×10⁻³mm²/s）和SU组（（1.52±0.23）×10⁻³mm²/s）（83.822，P<0.01）。克莱蒙评分和ADC值鉴别深部溃疡的曲线下面积（AUC）分别为0.887和0.733。克莱蒙评分或ADC值均可用于评估CD中的黏膜溃疡。在检测深部溃疡方面，克莱蒙评分比ADC值显示出更好的效能。
