Improved Comprehensive Evaluation of Crohn's Disease Activity by Intestinal Computed Tomography Enterography Combined with Endoscopy and Biochemical Indicators

Background: The treatment goal for Crohn’s disease (CD) has turned towards mucosal healing and resolution of the transmural inflammation. The purpose of this study was to evaluate how well computed tomography enterography (CTE) correlated with other treatments, in particular, endoscopy and biochemical indicators, in newly diagnosed patients with CD. Methods: 123 patients with CD who received CTE in the Xiangya Hospital of Central South University, China, from April 2017 to April 2019 were included. Clinical case data and imaging results were retrospectively reviewed. The clinical activity of CD was determined by the Crohn’s disease activity index (CDAI) score and biochemical indicators. The relationships between CTE and endoscopy, CDAI score, and inflammatory markers were evaluated. Results: The diagnostic rate of CTE in the 123 CD patients was 68.3% (84/123). Logistic regression analysis showed that the specific CTE manifestations related to CD activity were intestinal wall stratification, comb sign, and abdominal abscesses (P < 0.05). Spearman’s rank correlation analysis showed that inflammatory markers correlated positively with different CTE imaging manifestations. The CTE findings were consistent with colonoscopy results in 136 intestinal segments (73.1%) in terms of lesion location but were not consistent in 50 intestinal segments (26.9%). Conclusion: intestinal CTE has a high degree of completion and is well tolerated, in contrast to endoscopy which is both invasive and unable to reflect the level of intestinal mucosal infiltration. In conclusion, intestinal CTE combined with endoscopy and biochemical indicators is both comprehensive and effective in evaluating the condition of CD patients.