Xiao Wei-Xiong, Zhu Yu-Ting, Zhang Zhi-Chao, Luo Min, Ma Ming-Ping
Department of Radiology, Fujian Provincial Hospital, Provincial Clinical College of Fujian Medical University, Fuzhou, People's Republic of China.
Int J Gen Med. 2021 Oct 21;14:7051-7058. doi: 10.2147/IJGM.S331763. eCollection 2021.
To investigate the value of dual energy CT enterography (DECTE) in evaluating the activity of Crohn's disease (CD).
The endoscopy and imaging data of 29 patients with CD confirmed by clinic and pathology were analyzed retrospectively. The clinical CD activity index (CDAI) was used as the disease activity grouping standard, 29 patients with CD were grouped into activity groups, 18 patients in the active group (CDAI ≥ 150) with 36 intestinal segments, and 11 patients in the remission group (CDAI < 150) with 20 intestinal segments.The virtual single energy CT value, slope of energy spectrum curve and iodine content were analyzed to evaluate the evaluation of intestinal CD activity by DECTE.
There were statistically significant differences in virtual single energy CT value (except 90 keV and 100 keV virtual single energy CT value), curve slope and iodine content between remission group and active group (P < 0.05), and has more diagnostic value for active phase (AUC > 0.5). ① Virtual single energy CT value: the AUC of 60 keV in arterial phase was the highest (0.924). The specificity of diagnosing CD in active stage was high (95%). ② Curve slope: the AUC of portal vein phase was the largest (0.731). The specificity of diagnosing CD in active stage was higher (85%). ③ Iodine content: the AUC of arterial phase was the highest (0.885). The specificity of diagnosing CD lesions in the active stage was 100%.
The virtual single energy CT value, energy spectrum curve slope and iodine content can provide reference for clinical accurate diagnosis of CD activity.
探讨双能CT小肠造影(DECTE)在评估克罗恩病(CD)活动度中的价值。
回顾性分析29例经临床及病理确诊的CD患者的内镜及影像资料。以临床CD活动指数(CDAI)作为疾病活动分组标准,将29例CD患者分为活动组,其中活动期组18例(CDAI≥150),累及肠段36段;缓解期组11例(CDAI<150),累及肠段20段。分析虚拟单能量CT值、能谱曲线斜率及碘含量,以评估DECTE对肠道CD活动度的评估价值。
缓解期组与活动期组在虚拟单能量CT值(除90 keV及100 keV虚拟单能量CT值外)、曲线斜率及碘含量方面差异有统计学意义(P<0.05),且对活动期有较高诊断价值(AUC>0.5)。①虚拟单能量CT值:动脉期60 keV的AUC最高(0.924),诊断活动期CD的特异性高(95%)。②曲线斜率:门静脉期的AUC最大(0.731),诊断活动期CD的特异性较高(85%)。③碘含量:动脉期的AUC最高(0.885),诊断活动期CD病变的特异性为100%。
虚拟单能量CT值、能谱曲线斜率及碘含量可为临床准确诊断CD活动度提供参考。