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CT Enterography in Evaluating Postoperative Recurrence of Crohn’s Disease after Ileocolic Resection: Complementary Role to Endoscopy

Mao, Ren MD*; Gao, Xiang MD*; Zhu, Zhen-hua MD*; Feng, Shi-ting MD; Chen, Bai-li MD*; He, Yao MD*; Cui, Yi MD*; Li, Zi-ping MD; Hu, Pin-jin MD*; Chen, Min-hu MD*

doi: 10.1097/MIB.0b013e318280758c
Original clinical Articles

Background: Ileocolonoscopy is the gold standard to assess postoperative recurrence (POR) in patients with Crohn’s disease (CD) who have undergone ileocolic resection. Although computed tomographic enterography (CTE) yields striking findings in the small bowel of CD, its role in POR is undefined. The aim of this study was to compare ileocolonoscopy and CTE for evaluating POR in CD.

Methods: The analysis included 32 patients with CD with ileocolic resection. Ileocolonoscopy and CTE were performed within 1 week. Endoscopic recurrence was defined using Rutgeerts score (i0–i4), whereas CTE recurrence was assessed according to a previously validated CTE score (CTE0–CTE3). Patients were followed up for a maximum of 30 months, and the primary endpoint was reoperation.

Results: There was a good correlation between endoscopic and CTE recurrence (r = 0.782, P < 0.0001). Moreover, CTE identified the presence of jejunal and proximal ileum disease (n = 7), fistula (n = 3), and abscess (n = 4). Therapeutic management was thereby modified in 8 of 32 patients (25.0%). Eleven patients received major reoperation. There was no significant difference regarding the rate of reoperation between subgroups' Rutgeerts score i3–4 and i0–2 (P > 0.05), whereas there was significant difference between subgroups’ CTE2–CTE3 and CTE0–CTE1 (P < 0.05).

Conclusions: CTE is a reliable method in assessing POR in patients with CD who have undergone ileocolic resection. CTE may serve as an important complementary tool to endoscopy for evaluation of the postoperative course of CD.

Article first published online 18 March 2013

*Department of Gastroenterology and

Department of Radiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.

Reprints: Min-hu Chen, MD, Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-Sen University, 58 Zhongshan ‖ Road, Guangzhou 510080, China (e-mail:

This study was financially supported in part by the National Key Clinical Department in Ministry of Public Health, China (No. 303004269002), and Scientific Project of Guangzhou, China (No. 2011YZ-00004).

R. Mao and X. Gao contributed equally to this work.

The authors have no conflicts of interest to disclose.

Received July 29, 2012

Accepted August 06, 2012

© Crohn's & Colitis Foundation of America, Inc.
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