Diagnostic value of CT enterography and scoring system for moderate to severe Crohn's disease

HE Jiangtao; XUE Zhenlong; Wang Wei; ZHAO Yi

Abstract：Objective To explore the value of CT enterography(CTE)and scoring system in diagnosis of moderate to severe Crohn's disease(CD).Methods 55 patients with CD diagnosed by clinic,endoscopy or pathology were collected.Based on the Crohn's Disease Activity Index(CDAI)score,the patients were divided into 29 cases of remission to mild active group,and 26 cases of moderate to severe active group.The CTE signs of the two groups were analyzed.The binary logistic regression model was established,and the CTE score table was formulated according to the characteristic parameters.Results The analysis re-sults of CTE signs showed that there were significant differences in the bowel wall thickness,the average CT value in portal vein phase,the type of enhancement pattern,the increased mesenteric fat density and the increased mesenteric straight small vessels(comb sign)between the two groups(P<0.05).The three covariates of the bowel wall thickness(OR=3.717,95%CI:1.169～11.820),the average CT value of the portal vein(OR= 1.245,95%CI:1.037～1.496),and the type of enhancement pattern(OR = 8.077,95%CI:1.070～60.969)were statistically significant by using Logistic regression analysis.According to the receiver operating characteristic curve(ROC curve),the critical value of the CTE score for the diagnosis of moderate to severe CD pa-tients was 5 points,with a sensitivity of 96.2%,a specificity of 82.8%,and an area under the curve(AUC)of 0.968.Conclu-sion The bowel wall thickness,the average CT value of the portal vein and the type of enhancement pattern are characteristic parameters for the diagnosis of moderate and severe CD.The simple CTE scoring system can quantitatively evaluate the activity of CD.