Clinical outcome is distinct between radiological stricture and endoscopic stricture in ileal Crohn's disease

被引:3
作者
Shi, Li [1 ,2 ]
Wang, Yang-di [1 ]
Shen, Xiao-di [1 ]
Mao, Ren [3 ]
Meng, Ji-xin [1 ]
Huang, Si-yun [1 ]
Song, Ting [2 ]
Li, Zi-ping [1 ]
Feng, Shi-ting [1 ]
Lin, Shao-chun [1 ]
Peng, Zhen-peng [1 ]
Li, Xue-hua [1 ]
机构
[1] Sun Yat Sen Univ, Affiliated Hosp 1, Dept Radiol, 58 Zhongshan 2 Rd, Guangzhou 510080, Peoples R China
[2] Guangzhou Med Univ, Affiliated Hosp 3, Dept Radiol, 63 Duobao Rd, Guangzhou 510150, Peoples R China
[3] Sun Yat Sen Univ, Affiliated Hosp 1, Dept Gastroenterol, 58 Zhongshan 2 Rd, Guangzhou 510080, Peoples R China
基金
中国国家自然科学基金;
关键词
Crohn's disease; Strictures; Radiology; Endoscopy; Outcome; COMPUTED-TOMOGRAPHY; ENTEROGRAPHY; INDEX;
D O I
10.1007/s00330-023-09743-5
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
ObjectivesDifferences in clinical adverse outcomes (CAO) based on different intestinal stricturing definitions in Crohn's disease (CD) are poorly documented. This study aims to compare CAO between radiological strictures (RS) and endoscopic strictures (ES) in ileal CD and explore the significance of upstream dilatation in RS.MethodsThis retrospective double-center study included 199 patients (derivation cohort, n = 157; validation cohort, n = 42) with bowel strictures who simultaneously underwent endoscopic and radiologic examinations. RS was defined as a luminal narrowing with wall thickening relative to the normal gut on cross-sectional imaging (group 1 (G1)), which further divided into G1a (without upstream dilatation) and G1b (with upstream dilatation). ES was defined as an endoscopic non-passable stricture (group 2 (G2)). Strictures met the definitions of RS (with or without upstream dilatation) and ES were categorized as group 3 (G3). CAO referred to stricture-related surgery or penetrating disease.ResultsIn the derivation cohort, G1b (93.3%) had the highest CAO occurrence rate, followed by G3 (32.6%), G1a (3.2%), and G2 (0%) (p < 0.0001); the same order was found in the validation cohort. The CAO-free survival time was significantly different among the four groups (p < 0.0001). Upstream dilatation (hazard ratio, 1.126) was a risk factor for predicting CAO in RS. Furthermore, when upstream dilatation was added to diagnose RS, 17.6% of high-risk strictures were neglected.ConclusionsCAO differs significantly between RS and ES, and clinicians should pay more attention to strictures in G1b and G3. Upstream dilatation has an important impact on the clinical outcome of RS but may not be an essential factor for RS diagnosis.
引用
收藏
页码:7595 / 7608
页数:14
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