Quantitative assessment of transmural remission in Crohn's disease using low dose computed tomography (CT) enterography perfusion imaging: a single-centre study based on intestinal microcirculation

AIM: To assess transmural remission in patients with Crohn's disease using low-dose small bowel computed tomography (CT) perfusion scans. MATERIALS AND METHODS: Forty six patients were divided into active and remission phases based on Crohn's Disease Activity Index (CDAI) and C-reactive protein (CRP). Dual-source CT enterography with low-dose perfusion scans was conducted to generate perfusion parameter maps, including blood flow (BF), blood volume (BV), time to peak (TTP), mean transit time (MTT), and permeability of surface (PS). We compared differences in perfusion parameter values of intestinal walls, mesenteric fat, and lymph nodes between two groups. Receiver operating characteristic (ROC) curves were plotted, and area under the curve (AUC), sensitivity, specificity, and cutoff values were calculated. RESULTS: The BF, BV, TTP, MTT, and PS values of the intestinal wall were significantly higher in the active phase (P0.05). Additionally, lymph node BF and TTP displayed significant differences (P<0.01). CONCLUSION: Dual-source CT enterography with low-dose perfusion scans enables quantitative assessment of Crohn's disease microcirculation in intestinal walls, mesenteric fat, and lymph nodes. These quantitative indicators provide strong diagnostic efficacy and offer insights into whether the disease is in transmural remission. (c) 2024 Published by Elsevier Ltd on behalf of The Royal College of Radiologists.