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 26 May 2018

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News

CT enterography assesses ileal Crohn's activity

Quantitative measures of bowel enhancement at CT enterography correlate with endoscopic and histological severity, reports November's issue of Gut.

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Few studies have correlated computed tomography (CT) enterography findings with endoscopic severity and C-reactive protein concentrations.

Dr Fletcher and colleagues from Minnesota examined whether small bowel inflammation at computed tomography enterography correlates with endoscopic severity and C-reactive protein in Crohn's disease.

Computed tomography enterography datasets from 143 Crohn's patients undergoing ileoscopy were examined for 3 different parameters.

The research team evaluated computed tomography bowel enhancement, as defined by the ratio of terminal ileal versus control ileal loop attenuation.

Vascular enlargement of the vasa recta was also measured.

In addition, the team assessed mesenteric fat density.

C-reactive protein was elevated in patients with increased fat density
Gut

The researchers evaluated correlations between computed tomography scan parameters, endoscopy, histology severity scores, and C-reactive protein.

The team found that endoscopic score was significantly correlated with computed tomography bowel enhancement, comb sign, and fat density.

Correlations with histological inflammation were strongest for bowel enhancement.

The researchers observed that C-reactive protein was elevated in patients with increased fat density versus those with increased bowel enhancement only.

C-reactive protein did not differ significantly between patients without evidence of active Crohn's.

The researchers noted that C-reactive protein did not differ from those with bowel enhancement.

C-reactive protein also did not differ from endoscopic inflammation not involving the perienteric tissues by computed tomography.

Dr Fletcher's concludes, “Quantitative measures of bowel enhancement at computed tomography enterography correlate with endoscopic and histological severity.”

“C-reactive protein correlates with radiological findings of perienteric inflammation.”

“However, C-reactive protein did not correlate with inflammation limited to the small bowel wall.”

“This may underscore the potential role of perienteric inflammation in C-reactive protein response in Crohn's disease.”

Gut 2006: 55:1561-7
25 October 2006

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