Min Ju Kim MD, Abstract Co-Author: Nothing to Disclose

Eun Kyung Park, Presenter: Nothing to Disclose

Beom Jin Park MD, Abstract Co-Author: Nothing to Disclose

Deuk Jae Sung MD, Abstract Co-Author: Nothing to Disclose

Yu-Whan Oh MD, Abstract Co-Author: Nothing to Disclose

Kyoo Byung Chung MD, Abstract Co-Author: Nothing to Disclose

Few studies have correlated computed tomography (CT) enterography findings in the Crohn´s disease patients with Crohn´s Disease Activity Index (CDAI) and C reactive protein (CRP) concentrations. Our study evaluates small bowel enhancement characteristics and examine whether small bowel inflammation of CT enterography correlates with CDAI and CRP.

All patients with inflammatory bowel disease at our institution between March 2007 and March 2010 who had a CRP, ileocolonoscopy, and CT enterography performed within 14 days were identified. Twenty-eight patients (16 women, 12 men) had active inflammatory Crohn´s disease in the terminal ileum, proven by endoscopic biopsy, were enrolled in our study. Crohn´s Disease Activity Index was assessed through clinical or laboratory variables. CT enterography was performed after 120 mL of intravenous contrast material was administered at 4mL/sec, with 40-75 seconds delay, following 2 liters of sorbitol solution taken orally over 90 minutes prior to scan. Five different CT parameters were examined: mural hyperenhancement, mural thickness, mural stratification, comb sign (vascular enlargement of the vasa recta), and mesenteric fat density. Two gastrointestinal radiologists independently assessed all CT images by four-point scale and were blinded to all clinical and endoscopic information. Correlations between CT parameters, CRP, and CDAI were assessed using Spearman´s rank correlation and logistic regression analysis. The interobserver agreement between two radiologists for each CT parameters was also examined by using ĸ statistic.

The CDAI was significantly correlated with CT mural hyperenhancement, mural thickness, and mesenteric fat density in both reviewers (Spearman correlation coefficients 0.497-0.851; p<0.001). It also showed the correlation with CRP (r=0.547; p=0.010), age (r=-0.489; p=0.011), mural stratification (r=0.437-0.577; p<0.05), and comb sign (r=0.570-0.627; p<0.05). The binary logistic regression model indicated that only CRP (p=0.032, Exp(B)=1.080) influenced on severity of CDAI. CT parameters demonstrated the fair interobserver agreement.

The small bowel enhancement characteristics at CT enterography correlate with CDAI and CRP in the patients with Crohn´s disease.

CT enterography could be used as noninvasive diagnostic tool for predicting the activity of Crohn´s disease.

Kim, M, Park, E, Park, B, Sung, D, Oh, Y, Chung, K, Value of CT Enterography in Predicting Activity of Crohn´s Disease: Correlation with Crohn´s Disease Activity Index.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9013367.html