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자료유형
학술저널
저자정보
강초음 (연세대학교) 윤혜성 (연세대학교) 박소원 (연세대학교) 김지수 (연세대학교) 한경화 (연세대학교) 김승 (연세대학교) 고홍 (연세대학교) 이미정 (연세대학교) 신현주 (연세대학교)
저널정보
연세대학교 의과대학 Yonsei Medical Journal Yonsei Medical Journal 제63권 제7호
발행연도
2022.7
수록면
675 - 682 (8page)
DOI
10.3349/ymj.2022.63.7.675

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Purpose: To identify initial abdominal computed tomography (CT) and laboratory findings prior to a diagnosis of Crohn’s disease(CD) in children. Materials and Methods: In this retrospective study, patients (≤18 year-old) who were diagnosed with CD from 2004 to 2019 andhad abdominal CT just prior to being diagnosed with CD were included in the CD group. Patients (≤18 years old) who were diag nosed with infectious enterocolitis from 2018 to 2019 and had undergone CT prior to being diagnosed with enterocolitis were in cluded as a control group. We assessed the diagnostic performances of initial CT and laboratory findings for the diagnosis of CDusing logistic regression and the area under the curve (AUC). Results: In total, 107 patients (50 CD patients, 57 control patients) were included, without an age difference between groups (me dian 13 years old vs. 11 years old, p=0.119). On univariate logistic regression analysis, multisegmental bowel involvement, mesen teric vessel engorgement, higher portal vein/aorta diameter ratio, longer liver longitudinal diameter, lower hemoglobin (≤12.5 g/dL), lower albumin (≤4 g/dL), and higher platelet (>320×103/μL) levels were significant factors for CD. On multivariate analysis,multisegmental bowel involvement [odds ratio (OR) 111.6, 95% confidence interval (CI) 4.778–2605.925] and lower albumin levels(OR 0.9, 95% CI 0.891–0.993) were significant factors. When these two features were combined, the AUC value was 0.985 with asensitivity of 96% and specificity of 100% for differentiating CD. Conclusion: Multisegmental bowel involvement on CT and decreased albumin levels can help differentiate CD from infectiousenterocolitis in children prior to a definite diagnosis of CD.

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