Comparison of clinical and imaging features between colonic Crohn′s disease and ulcerative colitis
10.3760/cma.j.cn101480-20210610-00045
- VernacularTitle:结肠型克罗恩病与溃疡性结肠炎的临床影像特征对比分析
- Author:
Jie ZHOU
1
;
Biao LI
;
Decan KONG
;
Zicheng HUANG
;
Zhiyang ZHOU
;
Wuteng CAO
Author Information
1. 中山大学附属第六医院放射科，广州 510655
- Publication Type:Journal Article
- Keywords:
Colonic Crohn′s disease;
Ulcerative colitis;
Differential diagnosis;
Clinical and imaging characteristics
- From:
Chinese Journal of Inflammatory Bowel Diseases
2021;05(4):308-313
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical and imaging features of colonic Crohn′s disease (CD) and ulcerative colitis (UC) .Methods:A retrospective analysis was performed on 40 patients with colonic CD and 40 patients with UC who admitted to The Sixth Affiliated Hospital of Sun Yat-sen University from January 2013 to July 2020. All the patients underwent CT enterography examination and had complete clinical data. The differences of clinical and CT features between the two groups were compared. The characteristics ( P<0.05) were incorporated into the binary logistic regression model, and the predictors of diagnosing colonic CD were screened. Results:There were significant differences in age of onset (29.3 ± 10.7 vs. 46.6 ± 13.4, P<0.001) , body mass index [ (18.4 ± 2.7) kg/m 2 vs. (21.0 ± 4.0) kg/m 2, P=0.001] and ratio of bloody stool symptom (47.5% vs. 90.0%, P<0.001) between colonic CD group and UC group. Ascending colon involvement was more common in colonic CD than that in UC (70.0% vs. 20.0%, P<0.001) . Continuous distribution of lesions (80.0% vs. 57.5%, P = 0.03) and circumferential uniform thickening of intestinal wall (77.5% vs. 47.5%, P = 0.006) were more common in UC patients, peri-intestinal fat inflammation (20.0% vs. 67.5%, P<0.001) and anal fistula (10.0% vs. 57.5%, P<0.001) were less common in UC patients. It was more likely that the severity of different parts was inconsistent (75.0% vs. 45.0%, P = 0.006) , and the thickness of intestinal wall was thicker [ (9.5 ± 3.4) mm vs. (8.1 ± 2.2) mm, P = 0.024] in patients with colonic CD as compared to patients with UC. Multivariate regression models showed that involvement of ascending colon ( OR = 9.209, 95% CI: 2.238 to 37.902, P = 0.002) , peri-intestinal fat inflammation ( OR = 9.861, 95% CI: 2.384 to 40.786, P = 0.002) and anal fistula ( OR = 19.263, 95% CI: 3.714 to 99.905, P<0.001) are independent predictors for diagnosis of colonic CD. Conclusions:Combining with CT features and clinical manifestations, colonic CD and UC can be effectively distinguished, which provides an important reference value for further clinical treatment decision.
