Crohn's disease: A retrospective analysis between computed tomography enterography, colonoscopy, and histopathology

Saade, Charbel; Nasr, Layla; Sharara, Ala I.; Barada, Kassem; A, Soweid; Murad, Faris; Tawil, Ayman; Ghieh, Diamond; Asmar, Karl; Tamim, Hani; Khoury, Nabil

doi:10.1016/j.radi.2019.04.007

Cited by 13 publications

(9 citation statements)

References 32 publications

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“…Cytomegalo viruses were noted in 1.7% of patients, ECB in 6.8% of patients and Varicella zoster virus in 0.7% of patients as noted by (Bengi et al, 2018). Colonoscopy was the most frequent test of diagnostic with a rate of 79%, which is consistent with the results of 18 Among the 295 studied cases; a highly significant association was found between inflammatory pathology and Crohn's disease (44.7%). Of these, 7.1% are peritonitis, 2.4% are gastritis, 1.7% are UC, 0.7% are villous atrophy and COPD.…”

supporting

confidence: 87%

Association of Inflammatory Pathologies and Crohn's Disease: A Retrospective Study in the West Algerian Region

Benaissa

Kanoun

Zemri

et al. 2020

J. Drug Delivery Ther.

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Background: Crohn's disease is a chronic and recurrent inflammatory bowel disease that progresses slowly. Also CD patients have a large number of extra-intestinal manifestations. Objective: we sought to define the possible associations between inflammatory pathology and localization and on the other hand, inflammatory pathologies and the disease behavior Methods: A retrospective analytical study was carried out at the level of gastric and general surgery services of Western Algerian University Hospital of Sidi Bel Abbes region, during the period 2007-2019. Results Our study was based on a total sample of 295 cases involving 114 females (38.6%) and 181 males (61.4%) with a sex ratio of (1.58). The location of the disease at the time of diagnosis was dominated by the ileo-caecal location (55.3%), of which 64.4% were associated with inflammatory pathology (IP). The majority of patients diagnosed with Crohn's disease had an inflammatory behavior and this for all age groups. The appendix, the ulcer and inflammatory anemia are most associated with Crohn’s disease. For inflammatory extra-intestinal manifestations, only group of patients with arthralgia had significantly higher rates in the 20-60 age groups. The mainly noted risk factors were appendectomy with (17.3%), smoking (22.4%) with a highly significant association, and alcoholism (6.1%). Conclusion According to our results the association of inflammatory pathology and crohn disease is more frequent in male and dominated by arthralgia as extra-intestinal manifestations lesions. Keywords: Crohn disease; Inflammatory pathology; disease behavior; inflammatory extra-intestinal manifestation.

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supporting

confidence: 87%

Association of Inflammatory Pathologies and Crohn's Disease: A Retrospective Study in the West Algerian Region

Benaissa

Kanoun

Zemri

et al. 2020

J. Drug Delivery Ther.

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“…Since endoscopy can only show the inter surface of intestinal walls, it is impossible to explore the proliferation of vessels around the intestinal wall or the extra-intestinal diseases. Meanwhile, CTE, which is applied for a three-dimensional observation and is post-processed to reconstruct the sagittal and coronal plane of the images, can solve the problems of endoscopy [ 32 ]. For the extra-intestinal complications, such as a blurred peri-intestinal fat space and mesenteric vascular hyperplasia, the sensitivity of CTE remains at 80%–100% with an obvious advantage in evaluating the condition and activity of CD [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Efficiency of dual-energy computed tomography enterography in the diagnosis of Crohn’s disease

et al. 2021

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Background This retrospective study aimed to investigate the usefulness of the optimized kiloelectron volt (keV) for virtual monoenergetic imaging (VMI) combined with iodine map in dual-energy computed tomography enterography (DECTE) in the diagnosis of Crohn’s disease (CD). Methods Seventy-two patients (mean age: 41.89 ± 17.28 years) with negative computed tomography enterography (CTE) were enrolled for investigating the optimized VMI keV in DECTE by comparing subjective and objective parameters of VMIs that were reconstructed from 40 to 90 keV. Moreover, 68 patients (38.27 ± 15.10 years; 35 normal and 33 CD) were included for evaluating the diagnostic efficacy of DECTE iodine map at the optimized VMI energy level and routine CTE for CD and active CD. Statistical analysis for all data was conducted. Results Objective and subjective imaging evaluations showed the best results at 60 keV for VMIs. The CT values of the normal group, active subgroup, and CD group during the small intestinal phase at routine 120 kVp or 60 keV VMI had significant differences. The diagnostic efficacy of an iodine map was the best when NIC = 4% or fat value = 45.8% for CD, whereas NIC < 0.35 or the fat value < 0.38 for active CD. The combined routine CTE and optimized VMI improved the diagnostic efficacy (P < 0.001). Conclusions VMI at 60 keV provided the best imaging quality on DECTE. NIC and fat value provided important basis for active CD evaluation. Routine CTE combined with VMI at 60 keV improved the diagnostic efficiency for CD.

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“…The parameters central to CD activity on imaging, and thus response, are largely common to all imaging modalities. The most important and reliable parameter with the strongest prediction of disease activity and response is bowel-wall thickening 45,46 (BWT) as seen on CT, MRE, or IUS (>3 mm being the most common threshold for pathology), measured in the most affected part of the bowel 36,45,[47][48][49][50][51][52][53][54] (see Figure 3 for TR defined by IUS). However, BWT may reflect both active and chronic (fibrotic or muscular hypertrophy/-plasia) disease.…”

Section: Exploring Definitions Of Transmural Remission and Transmural Responsementioning

confidence: 99%

Relevance of monitoring transmural disease activity in patients with Crohn’s disease: current status and future perspectives

Wilkens

Novak

Panaccione

et al. 2021

Therap Adv Gastroenterol

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Treatment targets of inflammatory bowel diseases (IBD), ulcerative colitis (UC) and Crohn’s disease (CD) have evolved over the last decade. Goals of therapy consisting of symptom control and steroid sparing have shifted to control of disease activity with endoscopic remission being an important endpoint. Unfortunately, this requires ileocolonoscopy, an invasive procedure. Biomarkers [C-reactive protein (CRP) and fecal calprotectin (FCP)] have emerged as surrogates for endoscopic remission and disease activity, but also have limitations. Despite this evolution, we must not lose sight that CD involves transmural inflammation, not fully appreciated with ileocolonoscopy. Therefore, transmural assessment of disease activity by cross-sectional imaging, in particular with magnetic resonance enterography (MRE) and intestinal ultrasonography (IUS), is vital to fully understand disease control. Bowel-wall thickness (BWT) is the cornerstone in assessment of transmural inflammation and BWT normalization, with or without bloodflow normalization, the key element demonstrating resolution of transmural inflammation, namely transmural healing (TH) or transmural remission (TR). In small studies, achievement of TR has been associated with improved long-term clinical outcomes, including reduced hospitalization, surgery, escalation of treatment, and a decrease in clinical relapse over endoscopic remission alone. This review will focus on the existing literature investigating the concept of TR or residual transmural disease and its relation to other existing treatment targets. Current data suggest that TR may be the next logical step in the evolution of treatment targets.

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Crohn's disease: A retrospective analysis between computed tomography enterography, colonoscopy, and histopathology

Cited by 13 publications

References 32 publications

Association of Inflammatory Pathologies and Crohn's Disease: A Retrospective Study in the West Algerian Region

Association of Inflammatory Pathologies and Crohn's Disease: A Retrospective Study in the West Algerian Region

Efficiency of dual-energy computed tomography enterography in the diagnosis of Crohn’s disease

Relevance of monitoring transmural disease activity in patients with Crohn’s disease: current status and future perspectives

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