Li Shi1,2, Bao-Lan Lu1, Yun Qiu3, Li Huang1, Si-Yun Huang1, Ren Mao3, Jin-Jiang Lin1, Jin-Fang Du1, Shi-Ting Feng1, Zi-Ping Li1, Can-Hui Sun4, Xue-Hua Li5. 1. Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, 58 Zhongshan II Road, Guangzhou, 510080, People's Republic of China. 2. Department of Radiology, The Third Affiliated Hospital of Guangzhou Medical University, 63 Duobao Road, Guangzhou, 510150, People's Republic of China. 3. Department of Gastroenterology, The First Affiliated Hospital, Sun Yat-Sen University, 58 Zhongshan II Road, Guangzhou, 510080, People's Republic of China. 4. Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, 58 Zhongshan II Road, Guangzhou, 510080, People's Republic of China. sunch@mail.sysu.edu.cn. 5. Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, 58 Zhongshan II Road, Guangzhou, 510080, People's Republic of China. lxueh@mail.sysu.edu.cn.
Abstract
PURPOSE: This study aimed to evaluate the role of hepatic mosaic enhancement pattern (HMEP) on computed tomography images in the disease activity and therapeutic outcome of Crohn's Disease (CD). METHODS: Twenty-five CD patients with HMEP comprised the HMEP group, and 25 CD patients without HMEP, who had a similar onset age, sex, and disease course with those in the HMEP group, comprised the non-HMEP group. No underlying liver/biliary disease was observed in any of the patients. Clinical characteristics, laboratory test results, Lémann index, and CD endoscopic index of severity (CDEIS) were compared between the groups using the Student t-, Mann-Whitney U, Chi square, or Fisher's exact tests. Patients received top-down, step-up, or traditional treatment during the follow-up period. After the 1-year follow-up, therapeutic outcomes (active inflammation [CDEIS > 3.5 if the endoscopic data were available, or C-reactive protein level > 5 mg/L if the endoscopic data were unavailable] or remission) were evaluated. RESULTS: The occurrence rate of fistulas/abscesses was higher in the HMEP group (84%, 21/25) than in the non-HMEP group (48%, 12/25) with no statistical significance (P = 0.056). The HMEP group showed a higher C-reactive protein level (P = 0.001), erythrocyte sedimentation rate (P = 0.013), and blood platelet count (P = 0.005). There was no significant difference in therapeutic strategies between the groups (P = 0.509). The HMEP group showed a significantly lower remission ratio after anti-inflammatory treatment than the non-HMEP group (P = 0.045). CONCLUSIONS: HMEP was correlated with increased inflammatory activity and adverse therapeutic outcomes in CD. This finding provided insights regarding novel markers of CD diagnosis and treatment.
PURPOSE: This study aimed to evaluate the role of hepatic mosaic enhancement pattern (HMEP) on computed tomography images in the disease activity and therapeutic outcome of Crohn's Disease (CD). METHODS: Twenty-five CD patients with HMEP comprised the HMEP group, and 25 CD patients without HMEP, who had a similar onset age, sex, and disease course with those in the HMEP group, comprised the non-HMEP group. No underlying liver/biliary disease was observed in any of the patients. Clinical characteristics, laboratory test results, Lémann index, and CD endoscopic index of severity (CDEIS) were compared between the groups using the Student t-, Mann-Whitney U, Chi square, or Fisher's exact tests. Patients received top-down, step-up, or traditional treatment during the follow-up period. After the 1-year follow-up, therapeutic outcomes (active inflammation [CDEIS > 3.5 if the endoscopic data were available, or C-reactive protein level > 5 mg/L if the endoscopic data were unavailable] or remission) were evaluated. RESULTS: The occurrence rate of fistulas/abscesses was higher in the HMEP group (84%, 21/25) than in the non-HMEP group (48%, 12/25) with no statistical significance (P = 0.056). The HMEP group showed a higher C-reactive protein level (P = 0.001), erythrocyte sedimentation rate (P = 0.013), and blood platelet count (P = 0.005). There was no significant difference in therapeutic strategies between the groups (P = 0.509). The HMEP group showed a significantly lower remission ratio after anti-inflammatory treatment than the non-HMEP group (P = 0.045). CONCLUSIONS:HMEP was correlated with increased inflammatory activity and adverse therapeutic outcomes in CD. This finding provided insights regarding novel markers of CD diagnosis and treatment.
Authors: Laurent Peyrin-Biroulet; Walter Reinisch; Jean-Frederic Colombel; Gerassimos J Mantzaris; Asher Kornbluth; Robert Diamond; Paul Rutgeerts; Linda K Tang; Freddy J Cornillie; William J Sandborn Journal: Gut Date: 2013-08-23 Impact factor: 23.059
Authors: Benjamin Pariente; Jacques Cosnes; Silvio Danese; William J Sandborn; Maïté Lewin; Joel G Fletcher; Yehuda Chowers; Geert D'Haens; Brian G Feagan; Toshifumi Hibi; Daniel W Hommes; E Jan Irvine; Michael A Kamm; Edward V Loftus; Edouard Louis; Pierre Michetti; Pia Munkholm; Tom Oresland; Julian Panés; Laurent Peyrin-Biroulet; Walter Reinisch; Bruce E Sands; Juergen Schoelmerich; Stefan Schreiber; Herbert Tilg; Simon Travis; Gert van Assche; Maurizio Vecchi; Jean-Yves Mary; Jean-Frédéric Colombel; Marc Lémann Journal: Inflamm Bowel Dis Date: 2010-11-28 Impact factor: 5.325
Authors: Niels Vande Casteele; Reena Khanna; Barrett G Levesque; Larry Stitt; G Y Zou; Sharat Singh; Steve Lockton; Scott Hauenstein; Linda Ohrmund; Gordon R Greenberg; Paul J Rutgeerts; Ann Gils; William J Sandborn; Séverine Vermeire; Brian G Feagan Journal: Gut Date: 2014-10-21 Impact factor: 23.059