CT Enterography for Surveillance of Anastomotic Recurrence within 12 Months of Bowel Resection in Patients with Crohn's Disease: An Observational Study Using an 8-Year Registry
Korean Journal of Radiology
; : 906-914, 2017.
Article
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| WPRIM
| ID: wpr-191315
Biblioteca responsable:
WPRO
ABSTRACT
OBJECTIVE: To investigate the diagnostic yield and accuracy of CT enterography (CTE) for early (< 12 postoperative months) surveillance of anastomotic recurrence after bowel resection for Crohn's disease (CD). MATERIALS AND METHODS: We analyzed 88 adults (60 males and 28 females; mean age, 31.4 ± 9.6 years) who underwent bowel surgery for CD that created ileocolic anastomosis without enteric stoma, and underwent CTE for surveillance of CD recurrence/aggravation within 12 post-operative months. The CD activity index (CDAI) at the time of CTE was < 150 (i.e., clinically silent) in 51 patients, and ≥ 150 in 37 patients. Diagnostic yields of CTE regarding CD recurrence in the ileocolic anastomosis and extraluminal penetrating complications were determined. CTE-related step-up therapy was recorded. These outcomes were compared between the two CDAI groups after accounting for major risk factors for CD recurrence. In a subgroup of 31 patients who underwent both CTE and ileocolonoscopy within 1 month, CTE accuracy for anastomotic recurrence was assessed using the Rutgeerts scoring as the reference standard. RESULTS: CTE diagnostic yield was 35.2% (31/88) for the anastomotic recurrence and 9.1% (8/88) for penetrating complications. 20.5% (18/88) of the patients underwent step-up therapy after CTE detection of anastomotic recurrence. These outcomes were not significantly different between CDAI < 150 and CDAI ≥ 150, except that CTE yield for extraluminal penetrating complications was significantly higher in CDAI ≥ 150 (16.2% [6/37] vs. 3.9% [2/51]; multivariable-adjusted p = 0.029). CTE showed 92.3% (12/13) sensitivity and 83.3% (15/18) specificity for anastomotic recurrence. CONCLUSION: CTE may be a viable option for the early postsurgical surveillance of recurred disease in CD patients.
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Índice:
WPRIM
Asunto principal:
Recurrencia
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Enfermedad de Crohn
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Factores de Riesgo
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Estudios de Seguimiento
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Sensibilidad y Especificidad
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Estudio Observacional
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Intestinos
Tipo de estudio:
Diagnostic_studies
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Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
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Screening_studies
Límite:
Adult
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Female
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Humans
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Male
Idioma:
En
Revista:
Korean Journal of Radiology
Año:
2017
Tipo del documento:
Article