TY - JOUR
T1 - Using CT enterography to monitor Crohn's disease activity
T2 - A preliminary study
AU - Hara, Amy K.
AU - Alam, Shayan
AU - Heigh, Russell I.
AU - Gurudu, Suryakanth R.
AU - Hentz, Joseph G.
AU - Leighton, Jonathan A.
PY - 2008/6
Y1 - 2008/6
N2 - OBJECTIVE. The purpose of our study was to determine whether imaging changes of Crohn's disease at sequential CT enterography examinations correlate with disease progression or regression. MATERIALS AND METHODS. Forty CT enterography examinations in 20 patients (12 women, eight men; mean age, 55.5 years) with known Crohn's disease were retrospectively evaluated by a radiologist who was blinded to the clinical history. One radiologist determined whether imaging findings of Crohn's disease were present and, if so, whether the findings progressed, regressed, or remained stable between examinations. CT enterography findings were then compared with disease progression or regression based on symptoms and clinical follow-up. Direct comparison of CT enterography and endoscopy was also performed when available. RESULTS. Disease progression or regression by CT enterography correlated with symptoms in 16 of 20 (80%) patients. Specifically, CT enterography and symptoms agreed in 12 patients with clinical disease progression, two patients with clinical regression, and two with clinically stable disease. In four of 20 (20%) patients, symptoms progressed although CT enterography findings were negative (n = 2) or improved (n = 2). No treatment change was initiated; and at follow-up, three of four patients were improved and the remaining patient was stable symptomatically. Sixteen ileoscopies were attempted in 12 patients; however, four examinations did not reach the ileum. In the remaining examinations, endoscopy correlated with CT enterography in all cases (12/12, 100%) and with symptoms in nine of 12 (75%) cases. The weighted kappa statistic, which measures the chance-adjusted agreement between CT enterography and symptoms, was 0.57 (95% CI, 0.20-0.94). CONCLUSION. This preliminary study indicates that imaging changes between CT enterography examinations have excellent potential for reliably monitoring Crohn's disease progression or regression.
AB - OBJECTIVE. The purpose of our study was to determine whether imaging changes of Crohn's disease at sequential CT enterography examinations correlate with disease progression or regression. MATERIALS AND METHODS. Forty CT enterography examinations in 20 patients (12 women, eight men; mean age, 55.5 years) with known Crohn's disease were retrospectively evaluated by a radiologist who was blinded to the clinical history. One radiologist determined whether imaging findings of Crohn's disease were present and, if so, whether the findings progressed, regressed, or remained stable between examinations. CT enterography findings were then compared with disease progression or regression based on symptoms and clinical follow-up. Direct comparison of CT enterography and endoscopy was also performed when available. RESULTS. Disease progression or regression by CT enterography correlated with symptoms in 16 of 20 (80%) patients. Specifically, CT enterography and symptoms agreed in 12 patients with clinical disease progression, two patients with clinical regression, and two with clinically stable disease. In four of 20 (20%) patients, symptoms progressed although CT enterography findings were negative (n = 2) or improved (n = 2). No treatment change was initiated; and at follow-up, three of four patients were improved and the remaining patient was stable symptomatically. Sixteen ileoscopies were attempted in 12 patients; however, four examinations did not reach the ileum. In the remaining examinations, endoscopy correlated with CT enterography in all cases (12/12, 100%) and with symptoms in nine of 12 (75%) cases. The weighted kappa statistic, which measures the chance-adjusted agreement between CT enterography and symptoms, was 0.57 (95% CI, 0.20-0.94). CONCLUSION. This preliminary study indicates that imaging changes between CT enterography examinations have excellent potential for reliably monitoring Crohn's disease progression or regression.
KW - CT enterography
KW - Crohn's disease
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U2 - 10.2214/AJR.07.2877
DO - 10.2214/AJR.07.2877
M3 - Article
C2 - 18492900
AN - SCOPUS:44849142672
SN - 0361-803X
VL - 190
SP - 1512
EP - 1516
JO - American Journal of Roentgenology
JF - American Journal of Roentgenology
IS - 6
ER -