Enhancing the Differentiation between Intestinal Behçet’s Disease and Crohn’s Disease through Quantitative Computed Tomography Analysis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Patients
2.2. Assessment Items
2.3. Quantification of Body Composition Parameters Based on CTE
2.4. Imaging Technique
2.5. Statistical Analysis
3. Results
3.1. Clinical Date
3.2. Laboratory Results
3.3. Endoscopic Characteristics
3.4. Image Features
3.5. Body Composition Analysis
3.6. Identification Models
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Item | Intestinal BD (n = 20) | CD (n = 179) | p Value |
---|---|---|---|
Sex (male/female) | 11/9 | 143/36 | 0.025 |
Age (year) | 38.00 (33.25, 47.75) | 27.00 (23.00, 34.00) | <0.001 |
Disease course (month) | 3.00 (1.00, 12.00) | 10.00 (2.00, 24.00) | 0.059 |
Abdominal pain | 16 (80.0%) | 143 (79.9%) | >0.99 |
Diarrhea | 7 (35.0%) | 137 (76.5%) | <0.001 |
Fever | 3 (15.0%) | 36 (20.2%) | 0.794 |
Weight loss | 8 (40.0%) | 83 (46.4%) | 0.588 |
Gastrointestinal bleeding | 11 (55.0%) | 108 (60.3%) | 0.644 |
Oral ulcer | 16 (80.0%) | 10 (5.6%) | <0.001 |
Genital ulcer | 8 (40.0%) | 0 | <0.001 |
Intestinal symptoms as primary manifestation | 6 (30.0%) | 166 (93.3%) | <0.001 |
Perianal lesion | 0 | 109 (60.9%) | <0.001 |
CRP (mg/L) | 11.50 (2.48, 34.93) | 25.00 (10.50, 48.00) | 0.014 |
ESR (mm/h) | 16.00 (10.00, 28.75) | 23.00 (13.00, 40.00) | 0.149 |
Albumin (g/L) | 39.33 ± 6.41 | 37.20 ± 6.54 | 0.168 |
Range of albumin | 22.5–50.6 | 21.2–67.9 | |
Hemoglobin (g/L) | 113.80 ± 22.00 | 115.58 ± 22.66 | 0.739 |
Endoscope type | |||
Small intestine endoscopy | 3 | 40 | |
Colonoscopy | 18 | 145 | |
Longitudinal ulcer | 1 (5.0%) | 78 (43.6%) | <0.001 |
Ulcer distribution | 0.001 | ||
Focal | 15 (75.0%) | 51 (28.5%) | |
Segmental | 5 (25.0%) | 128 (71.5%) | |
Ileocecal valve deformity | 9 (45.0%) | 56 (31.3%) | 0.215 |
Noncaseating granuloma | 2 (10.0%) | 100 (56.2%) | <0.001 |
Item | Intestinal BD (n = 20) | CD (n = 179) | p Value | Kappa Value |
---|---|---|---|---|
Pattern of bowel wall thickening | <0.001 | 0.755 | ||
Polypoid | 10 (50.0%) | 19(10.6%) | ||
Homogeneous | 10 (50.0%) | 160 (89.4%) | ||
Enhancement pattern | 0.314 | 0.824 | ||
Layered | 11 (55.0%) | 123 (68.7%) | ||
Homogeneous | 9 (45.0%) | 56 (31.3%) | ||
Intestinal segment involvement | ||||
Jejunum | 1 (5.0%) | 17 (9.5%) | 0.799 | 0.939 |
Proximal ileum | 1 (5.0%) | 82 (45.8%) | <0.001 | 0.878 |
Terminal ileum | 12 (60.0%) | 135 (75.4%) | 0.137 | 0.884 |
Cecum | 16 (80.0%) | 119 (66.5%) | 0.220 | 0.884 |
Colorectum | 9 (45.0%) | 118 (65.9%) | 0.065 | 0.934 |
Ascending colon | 9 (45.0%) | 81 (45.3%) | 0.983 | 0.980 |
Transverse colon | 0 | 77 (43.0%) | <0.001 | 0.958 |
Descending colon | 0 | 67 (37.4%) | 0.001 | 0.966 |
Sigmoid colon | 0 | 72 (40.2%) | <0.001 | 0.968 |
Rectum | 0 | 55 (30.7%) | 0.004 | 0.889 |
Asymmetrical thickening of bowel wall | 3(15.0%) | 74 (41.3%) | 0.022 | 0.836 |
Comb sign | 6 (30.0%) | 134 (74.9%) | <0.001 | 0.803 |
Intestinal stenosis | 3 (15.0%) | 80 (44.7%) | 0.011 | 0.813 |
Penetration (sinus, fistula, abscess) | 3 (15.0%) | 11 (6.1%) | 0.314 | 0.802 |
Item | Intestinal BD (n = 20) | CD (n = 179) | p Value |
---|---|---|---|
VSRL1 | 0.86 (0.43, 1.78) | 1.26 (0.59, 3.51) | 0.086 |
VSRL2 | 0.91 (0.37, 1.47) | 1.11 (0.64, 2.00) | 0.063 |
VSRL3 | 0.75 (0.35, 1.17) | 0.91 (0.37, 1.47) | 0.088 |
VSRL4 | 0.68 (0.37, 0.96) | 0.81 (0.54, 1.40) | 0.046 |
VSRL5 | 0.59 (0.36, 0.95) | 0.85 (0.54, 1.40) | 0.013 |
VSRvolume | 0.77 (0.36, 1.11) | 0.97 (0.63, 1.35) | 0.072 |
CV | 0.23 (0.19, 0.44) | 0.35 (0.25, 0.51) | 0.039 |
L1 VAT attenuation (HU) | |||
25% quartile | −101.65 ± 14.84 | −90.18 ± 16.41 | 0.003 |
Median | −80.50 (−100.75, −70.00) | −68 (−82.00, −54.00) | 0.003 |
75% quartile | −57.00 (−78.25, −41.50) | −41.00 (−54.00, −28.00) | 0.001 |
L2 VAT attenuation (HU) | |||
25% quartile | −100.70 ± 12.77 | −90.69 ± 17.49 | 0.014 |
Median | −82.15 ± 15.18 | −69.91 ± 18.98 | 0.006 |
75% quartile | −56.50 (−75.75, −43.19) | −41.00 (−54.00, −29.00) | 0.001 |
L3 VAT attenuation (HU) | |||
25% quartile | −103.55 ± 12.89 | −93.38 ± 16.86 | 0.010 |
Median | −84.13 ± 15.71 | −71.84 ± 19.28 | 0.003 |
75% quartile | −60.50 (−77.25, −44.75) | −43.00 (−57.00, −30.00) | 0.002 |
L4 VAT attenuation (HU) | |||
25% quartile | −106.90 ± 9.71 | −93.48 ± 17.70 | 0.001 |
Median | −88.75 ± 12.69 | −71.80 ± 20.10 | <0.001 |
75% quartile | −68.00 (−77.50, −53.00) | −42.00 (−58.00, −29.00) | <0.001 |
L5 VAT attenuation (HU) | |||
25% quartile | −101.70 ± 13.29 | −90.13 ± 18.11 | 0.006 |
Median | −83.15 ± 16.15 | −69.19 ± 20.39 | 0.003 |
75% quartile | −59.50 (−79.75, −45.50) | −42.00 (−58.00, −28.00) | 0.001 |
Item | Traditional Model | Comprehensive Model | ||||
---|---|---|---|---|---|---|
p Value | OR | 95% CI | p Value | OR | 95% CI | |
Age | 0.002 | 1.069 | 1.025–1.116 | 0.016 | 1.060 | 1.011–1.112 |
Sex (male) | 0.253 | 0.523 | 0.172–1.589 | 0.887 | 0.908 | 0.239–3.456 |
Ulcer distribution (focal) | 0.001 | 7.020 | 2.290–21.524 | 0.001 | 10.772 | 2.738–42.383 |
Proximal ileum involvement | 0.007 | 0.045 | 0.005–0.435 | |||
Asymmetrical thickening of bowel wall | 0.167 | 0.308 | 0.058–1.637 | |||
Intestinal stenosis | 0.017 | 0.147 | 0.030–0.710 | |||
Area ratio of L4 VAT/SAT | 0.118 | 0.271 | 0.053–1.391 | |||
CV | 0.038 | 0.026 | 0.001-0.822 |
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Li, Y.; Xiong, Z.; Jiang, Y.; Shen, Y.; Hu, X.; Hu, D.; Li, Z. Enhancing the Differentiation between Intestinal Behçet’s Disease and Crohn’s Disease through Quantitative Computed Tomography Analysis. Bioengineering 2023, 10, 1211. https://doi.org/10.3390/bioengineering10101211
Li Y, Xiong Z, Jiang Y, Shen Y, Hu X, Hu D, Li Z. Enhancing the Differentiation between Intestinal Behçet’s Disease and Crohn’s Disease through Quantitative Computed Tomography Analysis. Bioengineering. 2023; 10(10):1211. https://doi.org/10.3390/bioengineering10101211
Chicago/Turabian StyleLi, Yuanqiu, Ziman Xiong, Yuchen Jiang, Yaqi Shen, Xuemei Hu, Daoyu Hu, and Zhen Li. 2023. "Enhancing the Differentiation between Intestinal Behçet’s Disease and Crohn’s Disease through Quantitative Computed Tomography Analysis" Bioengineering 10, no. 10: 1211. https://doi.org/10.3390/bioengineering10101211