title: Intestinal wall thickness detected by multidetector spiral computed tomography enterography predicts the disease severity of Crohn's disease.
abstract: OBJECTIVE
  Multidetector spiral computed tomography enterography (MSCTE) and ileocolonoscopy are used in evaluating inflammatory situation of Crohn's disease (CD) patients. The purpose of this study was to determine the disease severity of CD patients by combining the intestinal wall thickness by MSCTE with ileocolonoscopy.
  
  
  METHODS
  This retrospective study included 50 patients with terminal ileal CD. Diagnosis was confirmed based on clinical features, endoscopy, and pathology. Patients underwent both MSCTE and ileocolonoscopy. Ileal wall thickness was measured and the disease severity was evaluated by CD activity index (CDAI). Intestinal mucosal lesions were scored by the simple endoscopic score for CD (SES-CD).
  
  
  RESULTS
  Of the 50 patients with active terminal ileal CD, the comparison of scores between SES-CD and CDAI showed significant association with Spearman's rank correlation coefficient (p < 0.01). There were statistically significant correlation between the wall thickness and the SES-CD (p < 0.0001) as well as CDAI (p < 0.001), respectively, but no significant correlation between the wall thickness and the C-reactive protein (CRP) was found (p = 0.43). Moreover, we found that the wall thickness was preferential to predict the disease severity in the terminal ileal CD.
  
  
  CONCLUSIONS
  MSCTE, in combination with ileocolonoscopy, is reliable to identify disease severity in CD patients and provides more accurate information in the diagnosis and treatment.
authors.affiliation: Department of Gastroenterology, the Shanghai Tenth People's Hospital, Tongji University , Shanghai , China.
authors.forename: Xuehua
authors.initials: X
authors.lastname: Yang
authors.forename: Lijuan
authors.initials: L
authors.lastname: Yu
authors.forename: Weihua
authors.initials: W
authors.lastname: Yu
authors.forename: Maochun
authors.initials: M
authors.lastname: Tang
authors.forename: Chong
authors.initials: C
authors.lastname: He
authors.forename: Zhong
authors.initials: Z
authors.lastname: Li
authors.forename: Zhanju
authors.initials: Z
authors.lastname: Liu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003113:Colonoscopy; D003424:Crohn Disease / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D007082:Ileum / Q000000981:diagnostic imaging* / Q000473:pathology; D007413:Intestinal Mucosa / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D012189:Retrospective Studies; D012720:Severity of Illness Index; D055815:Young Adult
keywords: Crohn's disease; disease activity; multidetector spiral computed tomography enterography; simple endoscopic score for Crohn's disease; wall thickness