CT小肠成像及评分系统对中重度克罗恩病的诊断价值
Diagnostic value of CT enterography and scoring system for moderate to severe Crohn's disease
何江涛 1薛贞龙 2王苇 2赵义2
作者信息
- 1. 扬州大学附属医院医学影像中心放射科 江苏 扬州 225009;连云港市第四人民医院放射科 江苏 连云港 222023
- 2. 扬州大学附属医院医学影像中心放射科 江苏 扬州 225009
- 折叠
摘要
目的 探讨CT小肠成像(CTE)及评分系统在诊断中重度期克罗恩病(CD)中的价值.方法 选取经临床、肠镜或病理确诊的 55 例CD患者,依据克罗恩病活性指数(CDAI)评分将患者分为缓解和轻度活动组 29 例与中重度活动组 26 例.分析两组病变肠段CTE征象,建立二元Logistic回归模型,根据特征性参数制定CTE评分表.结果 CTE征象分析结果显示,两组间肠壁厚度、门静脉期平均CT值、肠壁强化方式、肠系膜脂肪密度增高、肠系膜直小血管增多(梳状征)的差异有统计学意义(P<0.05);二元Logistic回归分析显示,肠壁厚度(OR =3.717,95%CI:1.169～11.820)、门静脉期平均CT值(OR=1.245,95%CI:1.037～1.496)、强化方式(OR=8.077,95%CI:1.070～60.969)三个协变量差异有统计学意义.依据受试者工作特征曲线(ROC曲线)求得 CTE评分诊断中重度 CD患者的临界值为 5 分,其敏感性96.2%,特异性 82.8%,曲线下面积(AUC)0.968.结论 肠壁厚度、肠壁强化方式及门静脉期肠壁平均CT值是诊断CD中重度期的特征性参数,简易CTE评分系统可定量评估CD活动性.
Abstract
Objective To explore the value of CT enterography(CTE)and scoring system in diagnosis of moderate to severe Crohn's disease(CD).Methods 55 patients with CD diagnosed by clinic,endoscopy or pathology were collected.Based on the Crohn's Disease Activity Index(CDAI)score,the patients were divided into 29 cases of remission to mild active group,and 26 cases of moderate to severe active group.The CTE signs of the two groups were analyzed.The binary logistic regression model was established,and the CTE score table was formulated according to the characteristic parameters.Results The analysis re-sults of CTE signs showed that there were significant differences in the bowel wall thickness,the average CT value in portal vein phase,the type of enhancement pattern,the increased mesenteric fat density and the increased mesenteric straight small vessels(comb sign)between the two groups(P<0.05).The three covariates of the bowel wall thickness(OR=3.717,95%CI:1.169～11.820),the average CT value of the portal vein(OR= 1.245,95%CI:1.037～1.496),and the type of enhancement pattern(OR = 8.077,95%CI:1.070～60.969)were statistically significant by using Logistic regression analysis.According to the receiver operating characteristic curve(ROC curve),the critical value of the CTE score for the diagnosis of moderate to severe CD pa-tients was 5 points,with a sensitivity of 96.2%,a specificity of 82.8%,and an area under the curve(AUC)of 0.968.Conclu-sion The bowel wall thickness,the average CT value of the portal vein and the type of enhancement pattern are characteristic parameters for the diagnosis of moderate and severe CD.The simple CTE scoring system can quantitatively evaluate the activity of CD.
关键词
克罗恩病/体层摄影术,X线计算机/Logistic回归/CTE评分系统Key words
Crohn's disease/Tomography,X-ray computer/Logistic regression analysis/CTE score system引用本文复制引用
基金项目
江苏省扬州市科教强卫工程重点学科建设项目(十三五)(ZDXK201806)
出版年
2024
NETL
NSTL
维普
万方数据