中国中西医结合影像学杂志2025，Vol.23Issue(3)：303-308,370,7.DOI:10.3969/j.issn.1672-0512.2025.03.007
CT小肠造影特征与克罗恩病活动性的相关性分析及定量评分系统构建
Association of CT enterography features with Crohn's disease activity and development of a quantitative scoring system
摘要
Abstract
Objective:To explore the correlation between CT enterography(CTE)features and Crohn's disease activity,and to develop a quantitative scoring system for assessing Crohn's disease activity based on CTE features.Methods:A total of 45 patients with Crohn's disease were included.All patients underwent colonoscopy and CTE examinations.The simplified endoscopic score in Crohn's disease(SES-CD)was utilized to assess disease activity,and based on colonoscopy findings,the intestinal segments were divided into three groups,the no-lesion,non-ulcer lesion,and ulcer groups.The CTE features of the three groups were compared,including bowel wall enhanced CT value,relative enhanced CT value(ΔCT value),bowel wall thickness,lymph node size,stratification enhancement,comb sign,ulcer,stenosis and mesenteric fibrofatty proliferation.Multivariate logistic analysis was used for the independent risk factors of Crohn's disease activity and the endoscopic visible ulcer.The correlation between CTE features and Crohn's disease severity was analyzed,and a CTE score(CTES)was developed based on Tobit regression model of SES-CD.Results:A total of 215 bowel segments from 45 Crohn's disease patients were evaluated,including 107 segments in the no-lesion group,45 segments in the non-ulcer group,and 63 segments in the ulcer group.There were significant differences for SES-CD,bowel wall enhanced CT value,ΔCT value,bowel wall thickness,lymph node size,comb sign,and ulcer in the pairwise comparisons among the 3 groups(all P<0.05).Additionally,significant differences were observed for stratification enhancement between the no-lesion group and the non-ulcer or ulcer groups(both P<0.05),for narrow degree between the ulcer group and the no-lesion or non-ulcer groups(both P<0.05),for mesenteric fibrofatty proliferation between the no-lesion group and the ulcer group(P<0.05).Bowel wall thickness demonstrated the highest AUC for diagnosing Crohn's disease activity(AUC of 0.81)and endoscopic visible ulcer(AUC of 0.85).The bowel wall ΔCT value,bowel wall thickness,and stratification enhancement were the independent risk factors of Crohn's disease activity,and the AUC of the combined three features was 0.91.While the bowel wall ΔCT value and bowel wall thickness were the independent risk factors of the endoscopic visible ulcer,and the AUC of the combined two features was 0.92.The CTES was calculated using the Tobit regression model with the formula as follows:CTES=0.08×bowel wall ΔCT value+0.35×bowel wall thickness+2.80×stratification enhancement+2.51×comb sign.The AUCs of CTES for diagnosing Crohn's disease activity and endoscopic visible ulcer were 0.91 and 0.94,respectively.CTE features had weak to moderate correlations with SES-CD(all r<0.7),while the CTES was strongly correlated with SES-CD(r=0.86).Conclusions:CTE features are significantly correlated with Crohn's disease severity,and CTES shows a high accuracy for assessing Crohn's disease activity.关键词
克罗恩病/小肠造影术/体层摄影术,X线计算机Key words
Crohn's disease/Enterography/Tomography,X-ray computed引用本文复制引用
陈琢,许辉,张庆,刘陈平..CT小肠造影特征与克罗恩病活动性的相关性分析及定量评分系统构建[J].中国中西医结合影像学杂志,2025,23(3):303-308,370,7.基金项目
上海市卫生健康委员会科研项目(20214Y0063). （20214Y0063）
