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Crohn’s disease Activity: Abdominal Computed Tomography Histopathology Correlation

PURPOSE: Crohn’s disease is a type of inflammatory bowel disease affecting estimated 4 million people worldwide. Therapy stratification of Crohn’s disease (CD) is mainly based on the inflammatory activity being assessed by endoscopic biopsy and clinical criteria. Cross-sectional imaging allows for t...

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Autores principales: Paquet, N., Glickman, J.N., Erturk, S.M., Ros, P.R., Heverhagen, J.T., Patak, M.A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5144110/
https://www.ncbi.nlm.nih.gov/pubmed/27957517
http://dx.doi.org/10.1016/j.ejro.2016.03.001
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author Paquet, N.
Glickman, J.N.
Erturk, S.M.
Ros, P.R.
Heverhagen, J.T.
Patak, M.A.
author_facet Paquet, N.
Glickman, J.N.
Erturk, S.M.
Ros, P.R.
Heverhagen, J.T.
Patak, M.A.
author_sort Paquet, N.
collection PubMed
description PURPOSE: Crohn’s disease is a type of inflammatory bowel disease affecting estimated 4 million people worldwide. Therapy stratification of Crohn’s disease (CD) is mainly based on the inflammatory activity being assessed by endoscopic biopsy and clinical criteria. Cross-sectional imaging allows for the assessment of structural characteristics of the entire gastrointestinal tract including small bowel loops and may provide potential non-invasive image-based biomarkers for the inflammatory activity of CD. The aim of this study was to explore the predictive value of Computed Tomography-based morphologic patterns for inflammatory activity in CD. MATERIAL AND METHODS: 42 patients diagnosed with CD were included in a retrospective study (13 male, 29 female, median age 32 years). Abdominal CT imaging was carried out on symptomatic patients at a single institution 0–10 days prior to endoscopic biopsy or surgery using a protocol optimized for the characterization of structural bowel alterations. Image data were initially reviewed independently by three radiologists and discrepancies were settled in consensus with a focus on mesenteric fat stranding and combing, mesenteric adenopathy, mesenteric abscess, intraperitoneal free fluid, fistula, skip lesions, highest wall thickness and the localization of the affected bowel. The extent of inflammatory activity in the bowel wall was determined subsequently by histological analysis. RESULTS: All intestinal and extraintestinal CT findings except the mesenteric comb sign showed a tendency towards higher extent or prevalence in patients with high histological inflammatory activity score, especially median bowel wall thickness (6.0 mm vs. 3.5 mm), mesenteric abscesses (32% vs. 0%) and mesenteric adenopathy (94% vs. 45%). Spearman rank order correlation coefficient indicated a significant correlation of bowel wall thickness (r = 0.40, p < 0.05), mesenteric adenopathy (r = 0.54, p < 0.05), mesenteric abscess (r = 0.33, p < 0.05) and mesenteric fat stranding (r = 0.33, p < 0.05) with the histological inflammatory activity score. CONCLUSION: CT-based biomarkers including wall thickness, mesenteric fat stranding, mesenteric lymphadenopathy and mesenteric abscess positively correlated with the histological inflammatory activity score and therefore provided additional information for therapy stratification in symptomatic patients with CD, particularly as most of these biomarkers are hidden from endoscopy.
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spelling pubmed-51441102016-12-12 Crohn’s disease Activity: Abdominal Computed Tomography Histopathology Correlation Paquet, N. Glickman, J.N. Erturk, S.M. Ros, P.R. Heverhagen, J.T. Patak, M.A. Eur J Radiol Open Article PURPOSE: Crohn’s disease is a type of inflammatory bowel disease affecting estimated 4 million people worldwide. Therapy stratification of Crohn’s disease (CD) is mainly based on the inflammatory activity being assessed by endoscopic biopsy and clinical criteria. Cross-sectional imaging allows for the assessment of structural characteristics of the entire gastrointestinal tract including small bowel loops and may provide potential non-invasive image-based biomarkers for the inflammatory activity of CD. The aim of this study was to explore the predictive value of Computed Tomography-based morphologic patterns for inflammatory activity in CD. MATERIAL AND METHODS: 42 patients diagnosed with CD were included in a retrospective study (13 male, 29 female, median age 32 years). Abdominal CT imaging was carried out on symptomatic patients at a single institution 0–10 days prior to endoscopic biopsy or surgery using a protocol optimized for the characterization of structural bowel alterations. Image data were initially reviewed independently by three radiologists and discrepancies were settled in consensus with a focus on mesenteric fat stranding and combing, mesenteric adenopathy, mesenteric abscess, intraperitoneal free fluid, fistula, skip lesions, highest wall thickness and the localization of the affected bowel. The extent of inflammatory activity in the bowel wall was determined subsequently by histological analysis. RESULTS: All intestinal and extraintestinal CT findings except the mesenteric comb sign showed a tendency towards higher extent or prevalence in patients with high histological inflammatory activity score, especially median bowel wall thickness (6.0 mm vs. 3.5 mm), mesenteric abscesses (32% vs. 0%) and mesenteric adenopathy (94% vs. 45%). Spearman rank order correlation coefficient indicated a significant correlation of bowel wall thickness (r = 0.40, p < 0.05), mesenteric adenopathy (r = 0.54, p < 0.05), mesenteric abscess (r = 0.33, p < 0.05) and mesenteric fat stranding (r = 0.33, p < 0.05) with the histological inflammatory activity score. CONCLUSION: CT-based biomarkers including wall thickness, mesenteric fat stranding, mesenteric lymphadenopathy and mesenteric abscess positively correlated with the histological inflammatory activity score and therefore provided additional information for therapy stratification in symptomatic patients with CD, particularly as most of these biomarkers are hidden from endoscopy. Elsevier 2016-04-11 /pmc/articles/PMC5144110/ /pubmed/27957517 http://dx.doi.org/10.1016/j.ejro.2016.03.001 Text en © 2016 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Article
Paquet, N.
Glickman, J.N.
Erturk, S.M.
Ros, P.R.
Heverhagen, J.T.
Patak, M.A.
Crohn’s disease Activity: Abdominal Computed Tomography Histopathology Correlation
title Crohn’s disease Activity: Abdominal Computed Tomography Histopathology Correlation
title_full Crohn’s disease Activity: Abdominal Computed Tomography Histopathology Correlation
title_fullStr Crohn’s disease Activity: Abdominal Computed Tomography Histopathology Correlation
title_full_unstemmed Crohn’s disease Activity: Abdominal Computed Tomography Histopathology Correlation
title_short Crohn’s disease Activity: Abdominal Computed Tomography Histopathology Correlation
title_sort crohn’s disease activity: abdominal computed tomography histopathology correlation
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5144110/
https://www.ncbi.nlm.nih.gov/pubmed/27957517
http://dx.doi.org/10.1016/j.ejro.2016.03.001
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