title: Diagnostic utility of computer tomographic enterography for patients presenting with unexplained gastrointestinal symptoms.
abstract: OBJECTIVE
  Computer tomographic enterography (CTE) is gaining approval for evaluation of small bowel diseases. However, the diagnostic yields of CTE for diseases other than Crohn's disease have not yet been well elucidated. The aim of the present study was to determine the diagnostic utility of CTE and to ascertain the clinical factors predictive of the positive diagnostic rate in patients with unexplained gastrointestinal symptoms or signs.
  
  
  METHODS
  The clinical and radiological data of 193 patients with unexplained gastrointestinal symptoms that had a CTE examination at Severance Hospital between May 2007 and April 2010 were retrospectively analyzed.
  
  
  RESULTS
  CTE revealed positive findings that explained the symptoms in 51 of the 193 patients (diagnostic yield 26.4%). Positive findings of diagnosis included cancer (12 patients), Crohn's disease (10), intestinal stricture/obstruction (9), small bowel bleeding (7), colitis (6), intestinal Behcet's disease (4), intestinal tuberculosis (2) and intestinal fistula (1). According to univariate analysis, the positive findings of CTE were significantly associated with higher segmentated neutrophil count (p<0.001), higher erythrocyte sedimentation rate (ESR) (p=0.003), higher C-reactive protein (CRP) level (p=0.008) and lower serum albumin level (p=0.037). Multivariate analysis indicated that elevated CRP level was a significant risk factor for the positive findings of CTE (odds ratio 1.950; 95% CI (1.165-3.265), p=0.011).
  
  
  CONCLUSIONS
  The results of this study suggest that CTE could be helpful in patients suffering from unexplained gastrointestinal symptoms that cannot be explained by established examinations, especially those with elevated C-reactive protein levels.
authors: Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
authors: Hana
authors: H
authors: Park
authors: Jae Jun
authors: JJ
authors: Park
authors: Chang Mo
authors: CM
authors: Moon
authors: Sung Pil
authors: SP
authors: Hong
authors: Joon Seok
authors: JS
authors: Lim
authors: Myeong Jin
authors: MJ
authors: Kim
authors: Tae Ll
authors: TL
authors: Kim
authors: Won Ho
authors: WH
authors: Kim
authors: Jae Hee
authors: JH
authors: Cheon
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D016009:Chi-Square Distribution; D005260:Female; D005767:Gastrointestinal Diseases / Q000097:blood / Q000000981:diagnostic imaging* / Q000209:etiology; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein