Iago Rodríguez-Lago, Marta Aduna, Patricia Ramírez de la Piscina, Olga Merino, Juan Carrascosa, Rebeca Higuera, Ainara Maíz, Eva Zapata, José Luis Cabriada, Manuel Barreiro-de Acosta
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All cross-sectional examinations were centrally read, performing a descriptive analysis of the main findings and calculation of Lémann index.</p><p><strong>Results: </strong>Thirty-eight patients were included: 19 with preclinical CD (median age 55 years (IQR, 54-62), 53% male, 74% non-smokers; 74% B1 and 26% B2) and 19 matched-controls with symptomatic CD. In those with preclinical CD, the most frequent transmural findings on MRE were contrast enhancement (79%), wall thickening (79%), followed by lymphadenopathy (68%), edema (42%), and increased vascularity (42%). Among those with strictures, controls showed a higher rate of preestenotic dilation (100% vs. 0%, p = 0.01). Bowel damage assessment revealed no statistically significant differences in the Lémann index between preclinical CD and controls (p = 0.95). A statistically significant higher score in the colonic/rectum score was observed (p = 0.014).</p><p><strong>Conclusion: </strong>Patients with preclinical CD demonstrate similar radiological findings and degree of bowel damage as new-onset symptomatic CD.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":null,"pages":null},"PeriodicalIF":2.5000,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11176094/pdf/","citationCount":"0","resultStr":"{\"title\":\"Transmural cross-sectional findings and bowel damage assessment in preclinical Crohn's disease: a case-control study.\",\"authors\":\"Iago Rodríguez-Lago, Marta Aduna, Patricia Ramírez de la Piscina, Olga Merino, Juan Carrascosa, Rebeca Higuera, Ainara Maíz, Eva Zapata, José Luis Cabriada, Manuel Barreiro-de Acosta\",\"doi\":\"10.1007/s00384-024-04660-5\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Crohn's disease (CD) is a progressive disorder leading to cumulative bowel damage. 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引用次数: 0
摘要
目的:克罗恩病(CD)是一种进展性疾病,会导致累积性肠损伤。莱曼指数是一种经过验证的工具,有助于监测疾病的进展和评估不同疗法的效果。我们的目的是描述偶然诊断出的 CD 患者的主要放射学发现,并与后期诊断出的患者相比,评估该亚组患者的肠道损伤情况:方法:将在结直肠癌筛查项目中偶然诊断出 CD 的患者与对照组进行比较,对照组是在有症状发病后才诊断出 CD 的,并按疾病程度进行了 1:1 匹配。所有横断面检查均集中读取,对主要检查结果进行描述性分析,并计算莱曼指数:结果:共纳入 38 名患者:结果:共纳入 38 名患者:19 名临床前 CD 患者(中位年龄 55 岁(IQR,54-62),53% 为男性,74% 不吸烟;74% 为 B1 型,26% 为 B2 型)和 19 名有症状 CD 的匹配对照者。在临床前 CD 患者中,MRE 最常见的跨膜发现是造影剂增强(79%)、管壁增厚(79%),其次是淋巴结病(68%)、水肿(42%)和血管增生(42%)。在有狭窄的患者中,对照组显示出更高的狭窄前扩张率(100% 对 0%,P = 0.01)。肠道损伤评估显示,临床前 CD 与对照组之间的莱曼指数差异无统计学意义(P = 0.95)。结肠/直肠评分较高,具有统计学意义(p = 0.014):结论:临床前 CD 患者的放射学检查结果和肠道损伤程度与新发症状 CD 患者相似。
Transmural cross-sectional findings and bowel damage assessment in preclinical Crohn's disease: a case-control study.
Purpose: Crohn's disease (CD) is a progressive disorder leading to cumulative bowel damage. The Lémann index is a validated tool that can help in monitoring the progression of the disease and evaluating the effectiveness of different therapies. Our aim was to describe the main radiological findings in incidentally diagnosed CD and to evaluate bowel damage in this subgroup compared to patients diagnosed at later stages.
Methods: Patients with an incidental diagnosis of CD during the colorectal cancer screening program were compared to controls with a CD cohort diagnosed after symptomatic onset and matched 1:1 by disease extent. All cross-sectional examinations were centrally read, performing a descriptive analysis of the main findings and calculation of Lémann index.
Results: Thirty-eight patients were included: 19 with preclinical CD (median age 55 years (IQR, 54-62), 53% male, 74% non-smokers; 74% B1 and 26% B2) and 19 matched-controls with symptomatic CD. In those with preclinical CD, the most frequent transmural findings on MRE were contrast enhancement (79%), wall thickening (79%), followed by lymphadenopathy (68%), edema (42%), and increased vascularity (42%). Among those with strictures, controls showed a higher rate of preestenotic dilation (100% vs. 0%, p = 0.01). Bowel damage assessment revealed no statistically significant differences in the Lémann index between preclinical CD and controls (p = 0.95). A statistically significant higher score in the colonic/rectum score was observed (p = 0.014).
Conclusion: Patients with preclinical CD demonstrate similar radiological findings and degree of bowel damage as new-onset symptomatic CD.
期刊介绍:
The International Journal of Colorectal Disease, Clinical and Molecular Gastroenterology and Surgery aims to publish novel and state-of-the-art papers which deal with the physiology and pathophysiology of diseases involving the entire gastrointestinal tract. In addition to original research articles, the following categories will be included: reviews (usually commissioned but may also be submitted), case reports, letters to the editor, and protocols on clinical studies.
The journal offers its readers an interdisciplinary forum for clinical science and molecular research related to gastrointestinal disease.