Computed tomography enterography in assessment of Crohn's disease activity

Background: Monitoring the disease activity in Crohn's disease (CD) may be challenging with endoscopic manoeuvers due to difficulties in reaching the affected areas and being restricted to mucosal lesions, so the existence of a more tolerable and reliable technique will be highly warranted. Objectives: This study aims at detection of CD's activity by computed tomography enterography (CTE) in correlation with ileocolonoscopy evaluation as well as detection of extra-enteric manifestations and complications of the disease. Materials and methods: Twenty-four patients who were clinically and histopathologically proven as CD patients were retrospectively included in this study. Patients were divided into active and inactive groups according to ileocolonoscopic evaluation. All patients underwent CTE as clinically indicated within 1 week of ileocolonoscopy. Radiological parameters suggestive of Crohn's disease activity at CTE were interpreted at the terminal ileum and correlated to the corresponding ileocolonoscopy reports for signs of CD activity. Extra-enteric findings and complications of CD were also reported if present. Results: CTE was accurate in detecting CD activity in 15 out of 18 active cases (active group) and in detecting disease inactivity in 5 out of 6 inactive cases (inactive group) with sensitivity and specificity of 83.3%. Mural hyperenhancement was the most distinguished sign of CD activity in CTE. Conclusion: CTE is a non invasive and reliable technique that has a significant value in assessment of CD activity in correlation with endoscopy, hence, it is useful in follow up and preoperative guidance. (C) 2014 Alexandria University Faculty of Medicine. Production and hosting by Elsevier B.V. All rights reserved.