Yamamoto Shinji, Yoshida Nobukiyo, Sakurai Noriko, Ichikawa Atsushi, Takeshita Koji, Okada Yukinori
Department of Radiological Technology, Japan Community Healthcare Organization (JCHO) Tokyo Yamate Medical Center, Tokyo, JPN.
Department of Radiological Technology, Niigata University of Health and Welfare, Niigata, JPN.
Cureus. 2024 May 5;16(5):e59691. doi: 10.7759/cureus.59691. eCollection 2024 May.
Background Ulcerative colitis (UC) and Crohn's disease (CD) are classified as inflammatory bowel diseases (IBDs). However, they have different pathogeneses and treatment strategies and need to be differentiated. Purpose To determine the feasibility of differentiating UC from CD in patients with first-time IBD based on simple abdominal computed tomography (CT) findings. Methods We conducted a retrospective study of patients diagnosed with IBD for the first time at our hospital between January and December 2021. Age, sex, white blood cell count, albumin concentration, C-reactive protein concentration, visceral fat area, subcutaneous fat area, and psoas major volume were extracted and used to differentiate the two groups. Results Forty-three patients were selected. Their mean age was 35.60 ± 17.19 years, and 32 were male, while 11 were female. The visceral fat cross-sectional area was 51.80 cm for UC and 21.10 cm for CD (p < 0.01). The subcutaneous fat cross-sectional area was 108.30 cm for UC and 66.30 cm for CD (p = 0.049). The total protein concentration was 6.15 g/L for UC and 6.60 g/L for CD (p = 0.012). Receiver operating characteristic curve analysis of the visceral and subcutaneous fat cross-sectional areas showed areas under the curve, 95% confidence intervals, sensitivities, and specificities of 0.750 and 0.675, 0.603-0.897 and 0.507-0.844, 0.810 and 1.00, and 0.591 and 0.409, respectively, at cutoffs of 26.53 and 36.6 cm. Conclusions The visceral and subcutaneous fat cross-sectional areas determined with simple abdominal CT can differentiate UC from CD in patients with first-time IBD.
溃疡性结肠炎（UC）和克罗恩病（CD）被归类为炎症性肠病（IBD）。然而，它们具有不同的发病机制和治疗策略，需要进行鉴别。目的：基于简单的腹部计算机断层扫描（CT）结果，确定在初发性IBD患者中鉴别UC和CD的可行性。方法：我们对2021年1月至12月期间在我院首次诊断为IBD的患者进行了一项回顾性研究。提取年龄、性别、白细胞计数、白蛋白浓度、C反应蛋白浓度、内脏脂肪面积、皮下脂肪面积和腰大肌体积，用于区分两组。结果：选取43例患者。他们的平均年龄为35.60±17.19岁，男性32例，女性11例。UC的内脏脂肪横截面积为51.80 cm²，CD为21.10 cm²（p<0.01）。UC的皮下脂肪横截面积为108.30 cm²，CD为66.30 cm²（p = 0.049）。UC的总蛋白浓度为6.15 g/L，CD为6.60 g/L（p = 0.012）。对内脏和皮下脂肪横截面积进行的受试者工作特征曲线分析显示，在截断值分别为26.53和36.6 cm时，曲线下面积、95%置信区间、敏感性和特异性分别为0.750和0.675、0.603 - 0.897和0.507 - 0.844、0.810和1.00、0.591和0.409。结论：通过简单的腹部CT测定的内脏和皮下脂肪横截面积可以在初发性IBD患者中区分UC和CD。
