| Objectives:1.By respectively analyze the correlation of iodine value,spectrum curve slope with CDAI and CRP.ESR and CT findings, to research feasibility of iodine value and spectrum curve evaluate Crohn’s disease activity.2.By respectively analyze the correlation of Crohn’s disease’s CT findings with iodine value, spectrum curve slope, simplified CDAI and CRP, ESR,to study the ability of the CT image finding evaluate Crohn’s disease’s activity.Methods:29 cases which Collected from March September 2014 to 2015 in the First Affiliated Hospital of Kunming Medical University, adopted CTE dual energy dual phase enhanced scan and confirmed by pathology or clinical comprehensive diagnosis of Crohn’s disease patients,including 18 cases of male,11 female cases, with an average age of 38 year old. According to colonoscopy findings and CT findings to confirm the lesion sites, A graduate student statistic analysis and measured the intestinal wall maximum enhancement value, intestinal wall maximum thickness, the intestinal wall enhancement pattern, intestinal lymph nodes short diameter and perienteric phlegmon, mesenteric vessels "comb" sign change in venous phase. By processing workstation’s dual energy software, iodine maps and virtual single energy images which in venous phase were used to measure the iodine value and the energy spectrum curves’s lope of abnormal intestinal wall. According to the clinical records of a physician who did not participate in the evaluation of CT diagnosis according to the clinical records in accordance with the simplified Crohn’s disease activity index (CDAI) to calculate scores and estimate Crohn’s disease activity stage. Adopted result of the C-reactive protein (CRP) and the erythrocyte sedimentation rate (ESR) which ran the tests within 2 days of the day or before and after the CT examination. By SPSS22.0 statistical software package was used for statistical analysis, measurement data by all numbers plus standard difference (+s) in the form of said using the independent samples t test for statistical analysis, count data using the frequency (%) said, and statistical analysis was performed using chi square test, Spearman correlation analysis result were taken P< 0.05 as the difference was statistically significant.Results:Iodine value, energy spectrum curve slope and CRP has a significant positive correlation, P< 0.01. Iodine value and energy spectrum curve slope in CRP normal group and the inflammation group differences were statistically significant, P< 0.05, CRP inflammatory group the iodine value of the mean+standard difference is 3.05+0.49mg/ml, CRP inflammatory group to the slope of the curve of mean+standard spectrum difference is 3.22 +0.5. Iodine value and ESR has a positive correlation; iodine value in ESR of normal group and abnormal group, the difference was statistically significant, P< 0.05, iodine value of ESR abnormal group, the mean+standard difference is 3.18+0.49mm/h. The slope of the energy spectrum curve was not significantly correlated with ESR, P> 0.05. The slope of the energy spectrum curve in the normal group and abnormal group of ESR was not statistically significant. Iodine value, energy spectrum curve slope was not statistically significant difference in the simplified CDAI activity stage, P> 0.05. There was no significant correlation between iodine value, energy spectrum curve slope and the simplified CDAI score, P>0.05.In 29 patients with Crohn’s disease, the most common lesion location were terminal ileum(15,27.6%). The maximum thickness of the intestinal wall was 0.40-0.99cm (19 cases, 66%). The venous phase of intestinal wall maximum enhancement value to more than 100.00Hu was the most common (15 cases,52%). Homogeneous enhancement of the intestinal wall is most common (18 cases,62%). Short diameter of lymph nodes is 0.60-0.99cm which most common (22 cases,76%.).perienteric phlegmon(11 cases,38%), mesenteric vessels "comb" sign change(8cases,28%). Iodine value and the intestinal wall maximum thickness, intestinal wall maximum reinforcement value, intestinal wall strengthening, lymph nodes short diameter had positive correlation (P< 0.05), iodine number and perienteric phlegmon, mesenteric vessels "comb" sign change, there was no significant correlation (P> 0.05). Energy spectrum curve slope and the bowel wall enhancement have positive correlation (P< 0.05), spectral curve slope and intestinal wall thickness, maximum enhancement value, lymph node short diameter,perienteric phlegmon, mesenteric vessels "comb" sign have no significant correlation (P>0.05).Intestinal wall thickness, bowel wall enhancement and the maximum enhancement value, lymph node short diameter,perienteric phlegmon, mesenteric vessels "comb" sign in the simplified CDAI in various stages of differences do not have statistical significance (P> 0.05), simplified CDAI score and the bowel wall enhancement have the positive correlation (P> 0.05), simplified CDAI score of intestinal wall and maximum thickness and maximum enhancement value, lymph node short diameter, perienteric phlegmon, mesenteric vessels "comb" sign have no significant correlation (P> 0.05). The intestinal wall maximum enhancement value, intestinal wall reinforcement, lymph node short diameter and CRP, ESR have positive correlation (P< 0.05), intestinal wall maximum thickness,perienteric phlegmon, "comb" sign and CRP, ESR have no significant correlation (P> 0.05).Conclusions:1.1. When dual energy CT examination diagnosis Crohn’s disease,it can not only obtain the conventional image data, but also get dual energy iodine, iodine maps single energy spectrum, energy spectrum curve slope more radiographic image and indicators, and enrich the diagnostic information.2.The iodine value not only has correlation with ESR, CRP,but also has correlation with some CD activity CT findings (like thickening and enhancing of intestinal wall,intestinal wall layered (stratified) enhancement pattern and lymph nodes short size increases), iodine value in a certain extent can retlex the activity ot CD, but as a evaluate index or CD activity still need large sample studies support.3. energy spectrum curve slope has correlation with CRP, and has no correlation with ESR.energy spectrum curve slope only has correlation with intestinal wall enhancement pattern, the spectrum curve slope is not enough to become the index to evaluate CD activity.4. iodine value and spectrum curve slope have no correlation with simplified CDAI,and do not capable of evaluate CD activity stage according to simplified CDAI.5. The intestinal wall maximum enhancement value, intestinal wall enhancement pattern, lymph node short diameter is more capable in evaluate CD activity than intestinal wall maximum thickness, perienteric phlegmon, mesenteric vessels "comb" signt, the ability of... |
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