CT小肠造影综合评分评价克罗恩病活动度的敏感性及特异性研究

目的 探讨CT小肠造影(CTE)影像学评分在评估克罗恩病(CD)临床活动度中的价值.方法 回顾性收集经病理或临床确诊为CD的患者48例.分析与患者活动度有关的CTE征象,并对其进行评分,同时对患者进行临床经典克罗恩病活动度评分(CDAI).采用Pearson法分析CTE评分与CDAI之间的相关性,应用受试者工作特征(ROC)曲线分析CTE评分对CD临床活动度判断的诊断效能及最佳诊断阈值.结果 CTE评分与CDAI之间有良好的相关性(r=0.790,P<0.001).ROC曲线分析示曲线下面积(AUC)为0.913(P<0.001).最佳诊断阈值为5.5分.CTE评分≥5.5分时CD处于活动期,灵敏度为84.2％,特异度为80％,阳性预测值为94.1％,阴性预测值为57.1％,Youden指数为0.642.结论 CTE评分对CD临床活动度判断有较高的灵敏度及特异度.

The sensitivity and specificity of CT enterography comprehensive score in evaluating the activity of Crohn's disease

Objective To evaluate the value of CT enterography (CTE)imaging scores in assessing the clinical activity of Crohn's disease (CD).Methods Forty-eight patients with pathologically or clinically confirmed CD were collected retrospectively.The CTE findings associated with disease activity were analyzed and scored,and the well-known Crohn's disease activity index (CDAI)was also performed.The correlation between CTE score and CDAI score was analyzed by Pearson correlation method.The diagnostic efficacy and optimal diagnostic threshold of CTE score for clinical activity of CD were evaluated by ROC curve analysis.Results There was a good correlation between the CTE score and CDAI (r =0.790,P <0.001).ROC curve analysis showed the area under the curve (AUC)was 0.913 (P <0.001).The optimal diagnostic threshold was 5.5.A CTE score of 5.5 or above indicated the disease was active,with a sensitivity of 84.2％,specificity of 80％,positive predictive value of 94.1％,negative predictive value of 57.1％ and the Youden index of 0.642.Conclusion The CTE comprehensive score has high sensitivity and specificity for estimating clinical activity of CD.