title: Computed tomography enterography versus balloon-assisted enteroscopy for evaluation of small bowel lesions in Crohn's disease.
abstract: OBJECTIVE
  We aimed to assess the correlation between computed tomography enterography (CTE) and balloon-assisted enteroscopy on severity of small bowel lesions, and evaluated the accuracy of CTE parameters in assessing small intestine lesions in patients with Crohn's disease (CD).
  
  
  METHODS
  We performed an observational study of a single-center cohort. Data were retrieved from our inpatient databases starting from October 2007. Correlations between computed tomography parameters (bowel wall thickness, mural enhancement, comb sign, extramural findings, and stricture), endoscopic and histological severity scores, CD Activity Index [CDAI], and C-reactive protein were assessed using Spearman's rank correlation.
  
  
  RESULTS
  Seventy patients were included in this study. One hundred fifty-seven segments were examined. Bowel wall thickness (r = 0.6334, P < 0.0001), mural enhancement (r = 0.5477, P < 0.0001), comb sign (r = 0.5898, P < 0.0001), and extramural findings (r = 0.4754, P < 0.0001) were moderately correlated with the segmental Capsule Endoscopy CDAI. The segmental CTE score also moderately correlated with the segmental Capsule Endoscopy CDAI (r = 0.6714, P < 0.0001), while the total CTE score strongly correlated with the total Capsule Endoscopy CDAI (r = 0.7252, P < 0.0001). Both total CTE score (r = 0.5937, P < 0.0001) and total Capsule Endoscopy CDAI (r = 0.6364, P < 0.0001) correlated significantly with the Harvey-Bradshaw Index. Of five computed tomography parameters, bowel wall thickness have the best accuracy to detect small intestine lesions with an area under the receiver operating characteristic curve of 0.811 (P < 0.0001), with a sensitivity and specificity of 81.82% and 74.14%, respectively.
  
  
  CONCLUSIONS
  CTE is a reliable technique for detecting small intestine lesions in patients with CD, also provides accurate information on small bowel CD severity and activity, with close agreement to inflammatory markers, CDAI, and histopathology.
authors.affiliation: Division of Gastroenterology and Hepatology, Shanghai Jiao-Tong University School of Medicine Renji Hospital, Shanghai Institution of Digestive Disease, Shanghai, China.
authors.forename: Jin Lu
authors.initials: JL
authors.lastname: Tong
authors.forename: Qi
authors.initials: Q
authors.lastname: Feng
authors.forename: Jun
authors.initials: J
authors.lastname: Shen
authors.forename: Yu Qi
authors.initials: YQ
authors.lastname: Qiao
authors.forename: Qing
authors.initials: Q
authors.lastname: Zheng
authors.forename: Yan
authors.initials: Y
authors.lastname: Gu
authors.forename: Xiao Yu
authors.initials: XY
authors.lastname: Chen
authors.forename: Xiao Bo
authors.initials: XB
authors.lastname: Li
authors.forename: Jun
authors.initials: J
authors.lastname: Dai
authors.forename: Jia
authors.initials: J
authors.lastname: Hua
authors.forename: Jian Rong
authors.initials: JR
authors.lastname: Xu
authors.forename: Zhi Hua
authors.initials: ZH
authors.lastname: Ran
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003424:Crohn Disease / Q000175:diagnosis* / Q000473:pathology*; D058582:Double-Balloon Enteroscopy; D006801:Humans; D007421:Intestine, Small / Q000000981:diagnostic imaging* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D055815:Young Adult