Ileal Crohn's disease activity predicted by ruler: CT enterography histopathology correlation

Objective

The aim of this study was to explore the predictive value of CT enterography-based simple measurement tools for Crohn's disease activity.

Patients and methods

During one and half year duration 54 patients diagnosed with CD were retrospectively evaluated. All patients underwent CT enterography examinations following a preset protocol prior to endoscopic biopsy or surgery. The images obtained were reconstructed using dedicated software and workstations. The length of affected segments was calculated (L) and distance from ileocecal junction till first affected segment was measured (D). Results of CTE examinations were compared with histopathology.

Results

Out of 54 cases, 38 cases had single segment involvement (70.4%) and 16 cases had multiple affected segments (29.6%). The histological inflammatory activity score scored 1 in 10 cases (18.5%), 2 in 25 cases (46.3%) and 3 in 19 cases (35.2%). L varied from 1.4 cm to 20.6 cm while D varied from 0 to 6.7 cm. Spearman rank order correlation coefficient showed a strong uphill linear relationship of L (RHO = 0.663) and weak correlation of D (RHO = 0.222) with the histological inflammatory activity score.

Conclusion

CTE provides accurate data regarding length of affected ileal segments that positively correlated with histopathological score of disease activity.