Aims and objectives
CT Enterography (CTE) is a fundamental tool for the management of patients with Crohn’s Disease (CD),
allowing for a panoramic evaluation of disease extension and accurate detection of complications even in a sub-clinical stage [1; 2].
Imaging findings in CTE of patients with CD have been already described and correlated to clinical,
endoscopic or laboratory data [3; 4].
a structured and standardized evaluation of CTE findings improves diagnostic accuracy and communication with referring physician [4-6].
Several scoring systems,
based on different assumptions are available...
Methods and materials
Derivation of Inflammatory Score (I-Score)
We propose a semiquantitative score on a scale 0-4,
based on the literature review,
by considering intestinal and extraintestinal findings.
To reduce variability,
we evaluate qualitative parameters on a 3-point scale (0 = absent; 2 = marked – diffuse) and minimize or standardize numeric variables.
Among intestinal findings,
mural thickening (>3 mm) has a low sensitivity (29–67%) and a good specificity (80%-89%) for detection of active CD [10; 11].
Wall enhancement has a higher sensitivity (80%-86%) and a specificity of...
laboratory and endoscopic data are reported in Table 2.A total of 48 patients with a median age of 49 years were included.
A total of 63 intestinal segments were evaluated.
ROC curve analysis of I-Score and stenoses toward endoscopic data are reported in Figure 1.
Values of CRP and FC were stratified with I-Score categories by using Kruskal-Wallis Test,
as shown in Figure 2.
The proposed I-Score demonstrated high sensitivity in detection of active inflammation at CTE,
when compared with endoscopy.
defined as the diameter of involved segment as half of lumen of segments nearby,
demonstrated high sensitivity and specificity when compared to endoscopy.
The proposed I-Score is able to stratify values of CRP and FC.
Annese V et al (2017) 3rd European Evidence-based Consensus on the Diagnosis and Management of Crohn's Disease 2016: Part 1: Diagnosis and Medical Management.
J Crohns Colitis 11:3-25
Fletcher JG et al (2012) Benefit of computed tomography enterography in Crohn's disease: effects on patient management and physician level of confidence.
Inflamm Bowel Dis 18:219-225
Bonomo L (2009) CT findings and clinical activity in Crohn's disease.