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Faecal calprotectin and magnetic resonance imaging in detecting Crohn's disease endoscopic postoperative recurrence

World Journal of Gastroenterology 2018年第5期24卷 641-650页

作者： Pierre Baillet Guillaume Cadiot Marion Goutte Felix Goutorbe Hedia Brixi christine hoeffel Christophe Allimant Maud Reymond Hélène Obritin-Guilhen Benoit Magnin Gilles Bommelaer Bruno Pereira Constance Hordonneau Anthony Buisson Université Clermont Auvergne CHU Clermont-Ferrand Service de radiologie CHU de Reims Service d’Hépato-Gastro Entérologie Université Clermont Auvergne Inserm 3iHP CHU Clermont-Ferrand Service d’Hépato-Gastro Entérologie Université Clermont Auvergne Inserm U1071 CH de Bayonne Service d’Hépato-Gastro Entérologie CHU de Reims Service de radiologie CHU Clermont-Ferrand DRCI Unité de Biostatistiques

AIM To assess magnetic resonance imaging(MRI) and faecal calprotectin to detect endoscopic postoperative recurrence in patients with Crohn's disease(CD).METHODS From two tertiary centers, all patients with CD who underwent ileocolonic resection were consecutively and prospectively included. All the patients underwent MRI and endoscopy within the first year after surgery or after the restoration of intestinal continuity [median = 6 mo(5.0-9.3)]. The stools were collected the day before the colonoscopy to evaluate faecal calprotectin level. Endoscopic postoperative recurrence(POR) was defined as Rutgeerts' index ≥ i2b. The MRI was analyzed independently by two radiologists blinded from clinical *** Apparent diffusion coefficient(ADC) was lower in patients with endoscopic POR compared to those with no recurrence(2.03 ± 0.32 vs 2.27 ± 0.38 × 10^(-3) mm^2/s, P = 0.032). Clermont score(10.4 ± 5.8 vs 7.4 ± 4.5, P = 0.038) and relative contrast enhancement(RCE)(129.4% ± 62.8% vs 76.4% ± 32.6%, P = 0.007) were significantly associated with endoscopic POR contrary to the magnetic resonance index of activity(Ma RIA)(7.3 ± 4.5 vs 4.8 ± 3.7; P = 0.15) and MR scoring system(P = 0.056). ADC 100%(sensitivity = 0.75, specificity = 0.81, PPV = 0.75, NPV = 0.81) were the best cutoff values to identify endoscopic POR. Clermont score > 6.4(sensitivity = 0.61, specificity = 0.82, PPV = 0.73, NPV = 0.74), Ma RIA > 3.76(sensitivity = 0.61, specificity = 0.82, PPV = 0.73, NPV = 0.74) and a MR scoring system ≥ MR1(sensitivity = 0.54, specificity = 0.82, PPV = 0.70, and NPV = 0.70) demonstrated interesting performances to detect endoscopic POR. Faecal calprotectin values were significantly higher in patients with endoscopic POR(114 ± 54.5 μg/g vs 354.8 ± 432.5 μg/g; P = 0.0075). Faecal calprotectin > 100 μg/g demonstrated high perfor

关键词： Faecal calprotectin Magnetic resonance imaging Postoperative recurrence Crohn’s disease Clermont score Magnetic resonance index of activity

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Update on imaging of Peutz-Jeghers syndrome

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World Journal of Gastroenterology 2014年第31期20卷 10864-10875页

作者： Catherine Tomas Philippe Soyer Anthony Dohan Xavier Dray Mourad Boudiaf christine hoeffel Department of Radiology H?pital Robert Debré51092 Reims Cedex France Department of Abdominal Imaging H?pital Lariboisière-AP-HP and Université Diderot Paris 775475 Paris Cedex 10 France Department of Digestive Diseases H?pital Lariboisière-AP-HP and Université Diderot-Paris 775475 Paris Cedex 10 France

Peutz-Jeghers syndrome(PJS) is a rare, autosomal dominant disease linked to a mutation of the STK 11 gene and is characterized by the development of benign hamartomatous polyps in the gastrointestinal tract in association with a hyperpigmentation on the lips and oral mucosa. Patients affected by PJS have an increased risk of developing gastrointestinal and extra-digestive cancer. Malignancy most commonly occurs in the smallbowel. Extra-intestinal malignancies are mostly breast cancer and gynecological tumors or, to a lesser extent, pancreatic cancer. These polyps are also at risk of acute gastrointestinal bleeding, intussusception and bowel obstruction. Recent guidelines recommend regular smallbowel surveillance to reduce these risks associated with PJS. Small-bowel surveillance allows for the detection of large polyps and the further referral of selected PJS patients for endoscopic enteroscopy or surgery. Video capsule endoscopy, double balloon pushed enteroscopy,multidetector computed tomography and magnetic resonance enteroclysis or enterography, all of which are relatively new techniques, have an important role in the management of patients suffering from PJS. This review illustrates the pathological, clinical and imaging features of small-bowel abnormalities as well as the role and performance of the most recent imaging modalities for the detection and follow-up of PJS patients.

关键词： Peutz-Jeghers syndrome Small-bowel disease Small b

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