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Mesenteric abnormalities play an important role in grading intestinal fibrosis in patients with Crohn's disease: a computed tomography and clinical marker-based nomogram.
Meng, Jixin; Mao, Yitao; Zhou, Jie; Chen, Zhao; Huang, Siyun; Wang, Yangdi; Huang, Li; Zhang, Ruonan; Shen, Xiaodi; Lv, Wen; Xiao, Juxiong; Ye, Ziyin; Chen, Zhihui; Mao, Ren; Sun, Canhui; Li, Ziping; Feng, Shi-Ting; Lin, Shaochun; Li, Xuehua.
Afiliação
  • Meng J; Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China.
  • Mao Y; Department of Radiology, Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China.
  • Zhou J; Department of Radiology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China.
  • Chen Z; Department of Medical Imaging Center, Nan Fang Hospital, Southern Medical University, Guangzhou, People's Republic of China.
  • Huang S; Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China.
  • Wang Y; Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China.
  • Huang L; Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China.
  • Zhang R; Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China.
  • Shen X; Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China.
  • Lv W; Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China.
  • Xiao J; Department of Radiology, Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China.
  • Ye Z; Department of Pathology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China.
  • Chen Z; Department of Gastrointestinal and Pancreatic Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China.
  • Mao R; Department of Gastroenterology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China.
  • Sun C; Department of Gastroenterology, Hepatology and Nutrition, Digestive Diseases and Surgery Institute, Cleveland Clinic, Cleveland, Ohio, USA.
  • Li Z; Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China.
  • Feng ST; Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China.
  • Lin S; Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China.
  • Li X; Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan II Road, Guangzhou 510080, People's Republic of China.
Therap Adv Gastroenterol ; 15: 17562848221122504, 2022.
Article em En | MEDLINE | ID: mdl-36090482
ABSTRACT

Background:

While the grading of intestinal fibrosis is closely related to the therapeutic strategy of patients with Crohn's disease (CD), it has not yet been well resolved. Mesenteric abnormalities are inextricably linked to intestinal fibrosis.

Objectives:

We aimed to establish an optimal model for assessing intestinal fibrosis using computed tomography enterography (CTE) and clinical markers.

Design:

A total of 174 patients with CD between January 2014 and June 2020 were included in this retrospective multicentre study.

Methods:

All patients underwent CTE within 3 months prior to surgery. Intestinal fibrosis was pathologically scored as non-mild or moderate-to-severe. Selected imaging of the intestinal walls and mesentery and/or clinical factors were used to develop the diagnostic models. The area under the receiver operating characteristic curve (AUC) analysis was used to evaluate the discrimination performance of the models. A decision curve analysis was performed to evaluate the clinical usefulness of the models.

Results:

One-, two-, and three-variable models were identified as possible diagnostic models. Model 1 [mesenteric creeping fat index (MCFI)], Model 2 (mesenteric oedema and MCFI), and Model 3 (mesenteric oedema, MCFI, and disease duration) were established. The AUCs of Model 1 in training and test cohorts 1 and 2 were 0.799, 0.859, and 0.693, respectively; Model 2 was 0.851, 0.833, and 0.757, respectively; and Model 3 was 0.832, 0.821, and 0.850, respectively. We did not observe any significant difference in diagnostic performance between the training and total test cohorts in any model (all p > 0.05). The decision curves showed that Model 3 had the highest net clinical benefit in test cohort 2. The nomogram of this optimal model was constructed by considering the favourable and robust performance of Model 3.

Conclusion:

A nomogram integrating mesenteric abnormalities on CTE with a clinical marker was optimal for differentiating between non-mild and moderate-to-severe fibrosis in patients with CD.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Prognostic_studies Idioma: En Ano de publicação: 2022 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Prognostic_studies Idioma: En Ano de publicação: 2022 Tipo de documento: Article