Department of Radiology, NYU Langone Health, 660 1st Avenue, New York, NY, 10016, USA.
Department of Biostatistics, NYU Langone Health, 180 Madison Avenue, New York, NY, 10016, USA.
Abdom Radiol (NY). 2024 Jan;49(1):271-278. doi: 10.1007/s00261-023-04060-3. Epub 2023 Oct 9.
To determine optimal iodine density thresholds for active inflammation in CD patients with PCCT enterography and determine if iodine density can be used to stratify CD activity severity.
A retrospective PACS search identified patients with CD imaged with PCCT enterography from 4/11/2022 to 10/30/2022 and with clinical notes, endoscopic/surgical pathology and available source PCCT data for iodine density analysis. Two abdominal radiologists with expertise in CD each drew two region of interest measurements within the visibly most affected region of terminal or neoterminal ileum wall on commercially available system (SyngoVia). Radiologists were blinded to clinical information and pathologic findings. Disease activity and severity were recorded from the pathology report. Harvey-Bradshaw Index, medications, and laboratory values were recorded. Receiver operating characteristic (ROC) curves were utilized to determine the optimum iodine density threshold for active inflammation and mild versus moderate-to-severe inflammation. Intra- and inter-reader agreement was assessed by intra-class correlation coefficient (ICC).
23 CD patients (15 females; mean [SD] age: 52 [17] years) imaged with PCCT enterography were included. 15/23 had active inflammation: 9/15 mild, 4/15 moderate, and 2/15 severe active inflammation. The optimal iodine density threshold for active inflammation was 2.7 mg/mL, with 97% sensitivity, 100% specificity, and 98% accuracy (AUC = 1.00). The optimal iodine density threshold for distinguishing mild from moderate-to-severe inflammation was 3.4 mg/mL, with 83% sensitivity, 89% specificity, and 87% accuracy (AUC = 0.85). Intra-reader reliability (R1/R2) ICC was 0.81/0.86. Inter-reader reliability ICC was 0.94.
Iodine density from PCCT enterography can distinguish mild from moderate-to-severe active inflammation.
确定对比增强 CT 小肠造影术（PCCT）中 CD 患者活动性炎症的最佳碘密度阈值，并确定碘密度是否可用于分层 CD 活动严重程度。
回顾性 PACS 搜索确定了 2022 年 4 月 11 日至 2022 年 10 月 30 日期间因 CD 接受 PCCT 小肠造影检查且临床记录、内镜/手术病理和可用源 PCCT 数据可用于碘密度分析的患者。两位具有 CD 专业知识的腹部放射科医生在商业上可用的系统（SyngoVia）上在末端或新末端回肠壁的可见最受影响区域内分别绘制了两个感兴趣区域的测量值。放射科医生对临床信息和病理发现一无所知。从病理报告中记录疾病活动度和严重程度。记录 Harvey-Bradshaw 指数、药物和实验室值。利用受试者工作特征（ROC）曲线确定活动性炎症和轻度与中重度炎症的最佳碘密度阈值。使用组内相关系数（ICC）评估内部和读者间的一致性。
共纳入 23 例接受 PCCT 小肠造影检查的 CD 患者（15 例女性；平均[标准差]年龄：52[17]岁）。15/23 例有活动性炎症：9/15 例为轻度，4/15 例为中度，2/15 例为重度活动性炎症。活动性炎症的最佳碘密度阈值为 2.7mg/mL，灵敏度为 97%，特异性为 100%，准确性为 98%（AUC=1.00）。区分轻度与中重度炎症的最佳碘密度阈值为 3.4mg/mL，灵敏度为 83%，特异性为 89%，准确性为 87%（AUC=0.85）。内部读者可靠性（R1/R2）ICC 为 0.81/0.86。读者间可靠性 ICC 为 0.94。
PCCT 小肠造影术的碘密度可区分轻度与中重度活动性炎症。
