| 1 | Faecal calprotectin and magnetic resonance imaging in detecting Crohn's disease endoscopic postoperative recurrence显示文摘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 data.RESULTS 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 < 2.35 × 10^(-3) mm^2/s [sensitivity = 0.85, specificity = 0.65, positive predictive value(PPV) = 0.85, negative predictive value(NPV) = 0.65] and RCE > 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 performances to detect endoscopic POR(sensitivity = 0.67, specificity = 0.93, PPV = 0.89 and NPV = 0.77).CONCLUSION Faecal calprotectin and MRI are two reliable tools to detect endoscopic POR in patients with CD. | 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 | 2018 | World Journal of Gastroenterology2018，24，5： | 1 |
| 3 | Prospective study comparing hepatic steatosis assessment by magnetic resonance imaging and four ultrasound methods in 105 successive patients显示文摘BACKGROUND Non-alcoholic fatty liver disease(NAFLD)is becoming a major health problem,resulting in hepatic,metabolic and cardio-vascular morbidity.AIM To evaluate new ultrasonographic tools to detect and measure hepatic steatosis.METHODS We prospectively included 105 patients referred to our liver unit for NAFLD suspicion or follow-up.They underwent ultrasonographic measurement of liver sound speed estimation(SSE)and attenuation coefficient(AC)using Aixplorer MACH 30(Supersonic Imagine,France),continuous controlled attenuation parameter(cCAP)using Fibroscan(Echosens,France)and standard liver ultrasound with hepato-renal index(HRI)calculation.Hepatic steatosis was then classified according to magnetic resonance imaging proton density fat fraction(PDFF).Receiver operating curve(ROC)analysis was performed to evaluate the diagnostic performance in the diagnosis of steatosis.RESULTS Most patients were overweight or obese(90%)and had metabolic syndrome(70%).One third suffered from diabetes.Steatosis was identified in 85 patients(81%)according to PDFF.Twenty-one patients(20%)had advanced liver disease.SSE,AC,cCAP and HRI correlated with PDFF,with respective Spearman correlation coefficient of-0.39,0.42,0.54 and 0.59(P<0.01).Area under the receiver operating characteristic curve(AUROC)for detection of steatosis with HRI was 0.91(0.83-0.99),with the best cut-off value being 1.3(Se=83%,Sp=98%).The optimal cCAP threshold of 275 dB/m,corresponding to the recent EASL-suggested threshold,had a sensitivity of 72%and a specificity of 80%.Corresponding AUROC was 0.79(0.66-0.92).The diagnostic accuracy of cCAP was more reliable when standard deviation was<15 dB/m with an AUC of 0.91(0.83-0.98).An AC threshold of 0.42 dB/cm/MHz had an AUROC was 0.82(0.70-0.93).SSE performed moderately with an AUROC of 0.73(0.62-0.84).CONCLUSION Among all ultrasonographic tools evaluated in this study,including new-generation tools such as cCAP and SSE,HRI had the best performance.It is also the simplest and most available method as most ultrasound scans are equipped with this module. | Remi Collin Benoit Magnin Constance Gaillard Carine Nicolas Armand Abergel Benjamin Buchard | 2023 | World Journal of Gastroenterology2023，29，22： | 0 |
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