title: Comparison between clinical and radiological evaluation before and after medical therapy in patients with Crohn's disease: new prospective roles of CT enterography.
abstract: OBJECTIVE
  In recent years, CT enterography (CTE) has emerged as an important methodology to study patients with Crohn's disease (CD). The aim of this study was to evaluate the correlation between clinical response to therapy and CTE findings in CD patients.
  
  
  METHODS
  Forty-five patients with proven CD underwent CTE before and after medical therapy. In CTE we evaluated bowel thickness, longitudinal extension of parietal thickening, presence of target signs and extraintestinal signs. The clinical response to therapy was judged based on clinical global assessment and classified as improved, worsened or stable disease. Radiological judgement was compared to clinical judgement. The Cohen kappa test, t test or Anova analysis and χ (2) test were used for comparisons.
  
  
  RESULTS
  Among 45 enrolled patients, 21 (47 %) improved clinically, five (11 %) worsened, 19 (42 %) remained stable. Clinical improvement was significantly correlated to reduced intestinal thickness, reduced longitudinal extension of the disease, increased diameter of pathological bowel and reduced target signs (p < 0.05). Worsening conditions were significantly correlated to increased longitudinal extent, increased parietal thickness and reduced lumen diameter (p < 0.05). CT judgement was in agreement with physician's clinical assessment in 34 patients (76 %), showing improved disease in 16/21 patients (76 %), stable disease in 14/19 patients (74 %) and worsening in 4/5 patients (80 %). No agreement was observed in 11 (24 %) patients.
  
  
  CONCLUSIONS
  CT enterography provide specific and measurable parameters in evaluating the response to therapy in CD patients.
authors.affiliation: Department of Bio-imaging and Radiological Sciences, Catholic University of Sacred Heart, Lgo Gemelli 8, 00168, Rome, Italy, lmminordi@rm.unicatt.it.
authors.forename: Laura Maria
authors.initials: LM
authors.lastname: Minordi
authors.forename: Franco
authors.initials: F
authors.lastname: Scaldaferri
authors.forename: Luigi
authors.initials: L
authors.lastname: Larosa
authors.forename: Rosa
authors.initials: R
authors.lastname: Marra
authors.forename: Francesco
authors.initials: F
authors.lastname: Giordano
authors.forename: Lucrezia
authors.initials: L
authors.lastname: Laterza
authors.forename: Iolanda
authors.initials: I
authors.lastname: Scoleri
authors.forename: Andrea
authors.initials: A
authors.lastname: Poscia
authors.forename: Viviana
authors.initials: V
authors.lastname: Gerardi
authors.forename: Giovanni
authors.initials: G
authors.lastname: Bruno
authors.forename: Eleonora
authors.initials: E
authors.lastname: Gaetani
authors.forename: Antonio
authors.initials: A
authors.lastname: Gasbarrini
authors.forename: Amorino
authors.initials: A
authors.lastname: Vecchioli
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Bonomo
mesh_terms: D000328:Adult; D003424:Crohn Disease / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011857:Radiographic Image Interpretation, Computer-Assisted; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome