Computed tomographic (CT) enterography yields striking findings in the bowel wall in Crohn's disease.
These images may help to evaluate whether small bowel narrowing results from active disease requiring anti-inflammatory therapy.
However, the clinical relevance of these images is unknown.
It is also not known if these radiologic findings correlate with objective biomarkers of inflammation.
|CT data changed clinicians' perceptions of steroid benefit|
|Inflammatory Bowel Diseases|
Dr Peter Higgins and colleagues from Michigan evaluated 67 patients with Crohn's and suspicion of either small bowel inflammation or stricture.
Inflammatory bowel disease subspecialty gastroenterologists reviewed the clinical data.
Computed tomographic radiologists reviewed the computed tomographic enterography scans of the patients.
The research team made comparisons between clinical and radiologic assessments of inflammation and stricture.
The team also compared clinical assessments before and after computed tomographic (CT) enterography reports were revealed.
The team assessed the radiologic findings and objective biomarkers of inflammation.
The researchers found that individual computed tomographic enterography findings correlated poorly with clinical assessment.
The team observed that clinicians did not suspect 16% of radiologic strictures.
More than half the cases of clinically suspected strictures did not have them on computed tomographic enterography.
The team noted that computed tomographic enterography data changed clinicians' perceptions of the likelihood of steroid benefit in 41 of 67 cases.
Specific computed tomographic enterography findings correlated with C-reactive protein.
The team found that a distinct set of computed tomographic enterography findings correlated with erythrocyte sedimentation rates in patients who had these biomarkers measured.
Dr Higgins' team concluded, "Computed tomographic enterography seems to add unique information to clinical assessment."
"Computed tomographic enterography detected additional strictures, and changed clinicians' perceptions of the likelihood of steroids benefiting patients."
"The biomarker correlations suggest that computed tomographic enterography is measuring inflammatory biomarkers provides information distinct from that in a standard clinical assessment."