Department of Radiology, Children's Hospital of Fudan University, National Children's Medical Center, No. 399, Wanyuan Road, Minhang District, Shanghai, 201102, China.
Department of Radiology, Kunshan Hospital of Traditional Chinese Medicine, Nanjing University of Chinese Medicine, No. 189, Chaoyang Road, Kunshan, 215300, Jiangsu Province, China.
Abdom Radiol (NY). 2021 Sep;46(9):4121-4129. doi: 10.1007/s00261-021-03112-w. Epub 2021 May 15.
The aim of this study was to retrospectively determine if quantitative measurements of computed tomography enterography (CTE) imaging findings correlate with histopathologic scores from biopsy specimens in patients with Crohn's disease (CD).
CTE datasets of 34 CD patients (19 male and 15 female) who underwent endoscopy with biopsy within 25 days before or after CTE were retrospectively reviewed. CTE findings of segmental mural hyperenhancement, wall thickening, mural stratification and mesenteric findings were quantitatively measured in the corresponding segment. Histopathologic score of CD was based upon the Naini Cortina scoring system. Correlation between CTE findings and histopathologic scores was assessed using Spearman's rank correlation and logistic or linear regression analysis.
Neutrophilic inflammation contributed the most to the segmental mural hyperenhancement and explained 38.4% of the variance (R = 0.384, P = 0.006). Moreover, the increased lymphocytes and plasma cells predicted larger lymph node (P = 0.003) and increased attenuation in mesenteric fat (P = 0.022).
To a certain extent, macroscopic CTE findings may reflect the microscopic histopathologic state in the inflammatory stage of CD, underscoring that establishment of CTE scoring system may potentially provide an objective tool for assessment of disease progression.
本研究旨在回顾性确定克罗恩病（CD）患者的计算机断层扫描肠造影（CTE）影像学定量测量结果是否与活检标本的组织病理学评分相关。
回顾性分析了 34 例 CD 患者（19 名男性和 15 名女性）的 CTE 数据集，这些患者在 CTE 前或后 25 天内行内镜检查和活检。在相应节段定量测量 CTE 表现为节段性壁层强化、壁增厚、壁分层和肠系膜表现。CD 的组织病理学评分基于 Naini Cortina 评分系统。使用 Spearman 等级相关和逻辑或线性回归分析评估 CTE 发现与组织病理学评分之间的相关性。
中性粒细胞炎症对节段性壁层强化的贡献最大，解释了 38.4%的方差（R=0.384，P=0.006）。此外，增加的淋巴细胞和浆细胞预测更大的淋巴结（P=0.003）和肠系膜脂肪衰减增加（P=0.022）。
在一定程度上，宏观 CTE 表现可能反映了 CD 炎症期的微观组织病理学状态，这表明建立 CTE 评分系统可能为评估疾病进展提供一种客观的工具。
