Zhu Chao, Hu Jing, Rong Chang, Zhou Jianhua, Zhang Bo, Gao Yankun, Li Cuiping, Li Jianying, Wu Xingwang
Department of Radiology, The First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Shushan District, Hefei, 230022, Anhui Province, People's Republic of China.
Department of Gastroenterology, The First Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China.
Insights Imaging. 2023 Apr 13;14(1):63. doi: 10.1186/s13244-023-01397-7.
Mucosal healing (MH) is an important goal in the treatment of patients with Crohn's disease (CD). Noninvasive assessment of MH with normalized iodine concentration (NIC) is unknown.
In this retrospective study, 94 patients with diagnosed CD underwent endoscopy and dual-energy CT enterography (DECTE) at the post-infliximab treatment review. Two radiologists reviewed DECTE images by consensus for assessing diseased bowel segments of the colon or terminal ileum, and the NIC was measured. Patients were divided into transmural healing (TH), MH and non-MH groups. The diagnostic performance of the MH and non-MH groups with clinical factors and NIC was assessed utilizing receiver operating characteristic (ROC) curve analysis.
Of the 94 patients included in our study, 8 patients achieved TH, 34 patients achieved MH, and 52 patients did not achieve MH at the post-IFX treatment review. The area under the ROC curve (AUC), sensitivity, specificity, and accuracy values were 0.929 (95% confidence interval [CI] 0.883-0.967), 0.853, 0.827, and 0.837, respectively, for differentiating MHs from non-MHs, and the optimal NIC threshold was 0.448. The AUC of the combined model for distinguishing MHs from non-MHs in CD patients, which was based on the NIC and calprotectin, was 0.964 (95% CI 0.935-0.987).
The normalized iodine concentration measurement in DECTE has good performance in assessment MH in patients with CD. Iodine concentration from DECTE can be used as a radiologic marker for MH.
黏膜愈合（MH）是克罗恩病（CD）患者治疗的重要目标。碘浓度正常化（NIC）对MH进行无创评估尚不清楚。
在这项回顾性研究中，94例确诊为CD的患者在英夫利昔单抗治疗后复查时接受了内镜检查和双能CT小肠造影（DECTE）。两名放射科医生通过共识审查DECTE图像，以评估结肠或回肠末端的病变肠段，并测量NIC。患者分为透壁愈合（TH）、MH和非MH组。利用受试者操作特征（ROC）曲线分析评估MH组和非MH组与临床因素及NIC的诊断性能。
在我们纳入研究的94例患者中，8例实现了TH，34例实现了MH，52例在英夫利昔单抗治疗后复查时未实现MH。区分MH与非MH的ROC曲线下面积（AUC）、敏感性、特异性和准确性值分别为0.929（95%置信区间[CI]0.883 - 0.967）、0.853、0.827和0.837，最佳NIC阈值为0.448。基于NIC和钙卫蛋白区分CD患者中MH与非MH的联合模型的AUC为0.964（95%CI 0.935 - 0.987）。
DECTE中的碘浓度正常化测量在评估CD患者的MH方面具有良好性能。DECTE中的碘浓度可作为MH的影像学标志物。
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