在三级医疗中心的横断面成像中检测到炎症性肠病的狭窄、穿透性并发症和肠外表现的流行情况。
Prevalence of stricturing, penetrating complications and extraintestinal manifestations in inflammatory bowel disease detected on cross-sectional imaging in a tertiary care setting.
机构信息
Department of Medicine, Division of Gastroenterology, Western University Schulich School of Medicine, London, Ontario, Canada.
Division of Gastroenterology and Gastrointestinal Endoscopy, IRCCS Ospedale San Raffaele, Milan, Italy.
出版信息
United European Gastroenterol J. 2024 Sep;12(7):870-878. doi: 10.1002/ueg2.12635. Epub 2024 Jul 29.
BACKGROUND
Stricturing, penetrating complications and extraintestinal manifestations (EIMs) are frequent in patients with inflammatory bowel disease (IBD). There is limited data on the prevalence of these complications in patients with IBD. Therefore, we aimed to assess the burden of these complications detected incidentally on cross-sectional imaging.
METHODS
A retrospective study conducted at two tertiary care centers in London, Ontario. Patients (≥18 years) with a confirmed diagnosis of IBD who underwent CT enterography (CTE) or MR enterography (MRE) between 1 Jan 2010 and 31 Dec 2018 were included. Categorical variables were reported as proportions and the mean and standard deviations were reported for continuous variables.
RESULTS
A total of 615 imaging tests (MRE: 67.3% [414/615]) were performed in 557 IBD patients (CD: 91.4% [509/557], UC: 8.6% [48/557]). 38.2% (213/557) of patients were male, with mean age of 45.6 years (±15.8), and median disease duration of 11.0 years (±12.5). Among patients with CD, 33.2% (169/509) had strictures, with 7.8% having two or more strictures and 66.3% considered inflammatory. A fistula was reported in 10.6% (54/509), the most common being perianal fistula (27.8% [15/54]), followed by enterocutaneous fistula (16.8% [9/54]), and enteroenteric fistula (16.8% [9/54]). Additionally, 7.4% (41/557) of patients with IBD were found to have an EIM on cross-sectional imaging, with the most prevalent EIM being cholelithiasis (63.4% [26/41]), followed by sacroiliitis (24.4% [10/41]), primary sclerosing cholangitis (4.8% [2/41]) and nephrolithiasis (4.8% [2/41]).
CONCLUSIONS
Approximately 40% of patients with CD undergoing cross-sectional imaging had evidence of a stricture or fistulizing disease, with 7% of patients with IBD having a detectable EIM. These results highlight the burden of disease and the need for specific therapies for these disease phenotypes.
背景
狭窄、穿透性并发症和肠外表现（EIMs）在炎症性肠病（IBD）患者中很常见。关于 IBD 患者这些并发症的患病率，数据有限。因此，我们旨在评估在横断面成像上偶然发现这些并发症的负担。
方法
这是在安大略省伦敦的两个三级保健中心进行的一项回顾性研究。纳入了 2010 年 1 月 1 日至 2018 年 12 月 31 日期间接受 CT 肠造影术（CTE）或磁共振肠造影术（MRE）的确诊 IBD 患者（≥18 岁）。分类变量以比例表示，连续变量以平均值和标准差表示。
结果
557 例 IBD 患者共进行了 615 次影像学检查（MRE：67.3%[414/615]）（CD：91.4%[509/557]，UC：8.6%[48/557]）。38.2%（213/557）的患者为男性，平均年龄为 45.6 岁（±15.8），中位疾病持续时间为 11.0 年（±12.5）。在 CD 患者中，33.2%（169/509）有狭窄，7.8%有两个或更多狭窄，66.3%被认为是炎症性狭窄。报告了 10.6%（54/509）的瘘管，最常见的是肛周瘘管（27.8%[15/54]），其次是肠皮瘘管（16.8%[9/54]）和肠肠瘘管（16.8%[9/54]）。此外，557 例 IBD 患者中有 7.4%（41/557）在横断面成像上发现肠外表现（EIM），最常见的是胆石症（63.4%[26/41]），其次是骶髂关节炎（24.4%[10/41]）、原发性硬化性胆管炎（4.8%[2/41]）和肾结石（4.8%[2/41]）。
结论
约 40%接受横断面成像的 CD 患者有狭窄或瘘管疾病的证据，7%的 IBD 患者有可检测到的肠外表现。这些结果强调了疾病的负担以及针对这些疾病表型的特定治疗的必要性。
Zotero 插件