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
- Authors
- Choi, In Young; Park, Sang Hyoung; Park, Seong Ho; Yu, Chang Sik; Yoon, Yong Sik; Lee, Jong Lyul; Ye, Byong Duk; Kim, Ah Young; Yang, Suk-Kyun
- Issue Date
- 11월-2017
- Publisher
- KOREAN RADIOLOGICAL SOC
- Keywords
- Crohn' s disease; Ileocolonic; Intestine; Follow-up; CT enterography; CTE; Monitor; Recurrent; Asymptomatic
- Citation
- KOREAN JOURNAL OF RADIOLOGY, v.18, no.6, pp.906 - 914
- Indexed
- SCIE
SCOPUS
KCI
- Journal Title
- KOREAN JOURNAL OF RADIOLOGY
- Volume
- 18
- Number
- 6
- Start Page
- 906
- End Page
- 914
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/81683
- DOI
- 10.3348/kjr.2017.18.6.906
- ISSN
- 1229-6929
- 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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