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Computed Tomography Enterography in Differentiating Crohn Disease and Intestinal Tuberculosis-a Preliminary Study

Author: YuChen
Tutor: XiaoXiangZuo
School:
Course: Medical Imaging and Nuclear Medicine
Keywords: Crohn disease Intestinal tuberculosis Differential diagnosis CTenterography Imageology parameters
CLC: R816.5
Type: Master's thesis
Year: 2013
Downloads: 22
Quote: 0
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Abstract


Objective: To discuss the feasibility of differentiating Crohn disease fromintestinal tuberculosis when using the computed tomography enterography (CTE) as adiagnostic tool, and to evaluate the diagnostic value of which in the differentialdiagnosis between intestinal tuberculosis and Crohn disease.Methods: We reviewed the imageology data of CTE from patients who wereadmitted in The First Affiliated Hospital of Nanchang University from August2011toJuly2012, and were finally diagnosed as Crohn disease and intestinal tuberculosisafter follow-up. Two gastrointestinal physicians with associate professors title wasasked to evaluate radiologic signs blindly through a systemic approach. The findingsof these patient(19cases each) who has small intestine involed were analyzed.Results: Five parameters (mural stratification enhancement, asymmetric wallthickening, multi-segment skip lesions, fibro-fatty proliferation, engorged vasa recta)were significantly more common in patients with Crohn disease than in patients withintestinal tuberculosis. While three other parameters (mural heterogeneousenhancement, symmetric wall thickening, peripheral enhancement in lymph nodes)were observed more frequently in patients with intestinal tuberculosis than in patientswith Crohn disease. We assigned a score of+1to the five radiologic parameters thatare characteristic of Crohn disease and–1to the other three parameters, whichindicate intestinal tuberculosis. The threshold acquired by ROC curve was1.5, weconsidered the diagnosis to be Crohn disease when the sum of the scores for the eightparameters was greater than1.5, and to be intestinal tuberculosis when opposite.Making these assumptions, we calculated that the diagnosis of either intestinaltuberculosis or Crohn disease would have been made correctly in34of our38patients (89.5%), incorrectly in four patients (10.5%).Conclusion: A systematic analysis of radiologic findings is very useful in thedifferential diagnosis between intestinal Crohn disease and tuberculosis.

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CLC: > Medicine, health > Of Medical > Radiation Medicine > Each location and course of disease X - ray diagnosis and therapy > Stomach and digestive
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