Abstract：
BACKGROUND: Stricturing, penetrating complications and extraintestinal manifestations (EIMs) are frequent in patients with inflammatory bowel disease (IBD). There is limited data on the prevalence of these complications in patients with IBD. Therefore, we aimed to assess the burden of these complications detected incidentally on cross-sectional imaging.
METHODS: A retrospective study conducted at two tertiary care centers in London, Ontario. Patients (≥18 years) with a confirmed diagnosis of IBD who underwent CT enterography (CTE) or MR enterography (MRE) between 1 Jan 2010 and 31 Dec 2018 were included. Categorical variables were reported as proportions and the mean and standard deviations were reported for continuous variables.
RESULTS: A total of 615 imaging tests (MRE: 67.3% [414/615]) were performed in 557 IBD patients (CD: 91.4% [509/557], UC: 8.6% [48/557]). 38.2% (213/557) of patients were male, with mean age of 45.6 years (±15.8), and median disease duration of 11.0 years (±12.5). Among patients with CD, 33.2% (169/509) had strictures, with 7.8% having two or more strictures and 66.3% considered inflammatory. A fistula was reported in 10.6% (54/509), the most common being perianal fistula (27.8% [15/54]), followed by enterocutaneous fistula (16.8% [9/54]), and enteroenteric fistula (16.8% [9/54]). Additionally, 7.4% (41/557) of patients with IBD were found to have an EIM on cross-sectional imaging, with the most prevalent EIM being cholelithiasis (63.4% [26/41]), followed by sacroiliitis (24.4% [10/41]), primary sclerosing cholangitis (4.8% [2/41]) and nephrolithiasis (4.8% [2/41]).
CONCLUSIONS: Approximately 40% of patients with CD undergoing cross-sectional imaging had evidence of a stricture or fistulizing disease, with 7% of patients with IBD having a detectable EIM. These results highlight the burden of disease and the need for specific therapies for these disease phenotypes.
METHODS: A retrospective study conducted at two tertiary care centers in London, Ontario. Patients (≥18 years) with a confirmed diagnosis of IBD who underwent CT enterography (CTE) or MR enterography (MRE) between 1 Jan 2010 and 31 Dec 2018 were included. Categorical variables were reported as proportions and the mean and standard deviations were reported for continuous variables.
RESULTS: A total of 615 imaging tests (MRE: 67.3% [414/615]) were performed in 557 IBD patients (CD: 91.4% [509/557], UC: 8.6% [48/557]). 38.2% (213/557) of patients were male, with mean age of 45.6 years (±15.8), and median disease duration of 11.0 years (±12.5). Among patients with CD, 33.2% (169/509) had strictures, with 7.8% having two or more strictures and 66.3% considered inflammatory. A fistula was reported in 10.6% (54/509), the most common being perianal fistula (27.8% [15/54]), followed by enterocutaneous fistula (16.8% [9/54]), and enteroenteric fistula (16.8% [9/54]). Additionally, 7.4% (41/557) of patients with IBD were found to have an EIM on cross-sectional imaging, with the most prevalent EIM being cholelithiasis (63.4% [26/41]), followed by sacroiliitis (24.4% [10/41]), primary sclerosing cholangitis (4.8% [2/41]) and nephrolithiasis (4.8% [2/41]).
CONCLUSIONS: Approximately 40% of patients with CD undergoing cross-sectional imaging had evidence of a stricture or fistulizing disease, with 7% of patients with IBD having a detectable EIM. These results highlight the burden of disease and the need for specific therapies for these disease phenotypes.
摘要：
背景：严格，炎症性肠病(IBD)患者常见穿透性并发症和肠外表现(EIMs).关于IBD患者中这些并发症的患病率的数据有限。因此,我们旨在评估横断面成像中偶然发现的这些并发症的负担.
方法：在伦敦的两个三级护理中心进行的回顾性研究，安大略省。纳入在2010年1月1日至2018年12月31日期间接受CT小肠造影（CTE）或MR小肠造影（MRE）的确诊为IBD的患者（≥18岁）。分类变量报告为比例,并且报告连续变量的平均值和标准偏差。
结果：557例IBD患者共进行了615次影像学检查（MRE：67.3％[414/615]）（CD：91.4％[509/557]，UC:8.6%[48/557])。38.2%(213/557)的患者为男性,平均年龄45.6岁（±15.8），中位病程为11.0年（±12.5）。在CD患者中，33.2%(169/509)有狭窄，7.8%有两个或两个以上狭窄，66.3%认为是炎症。在10.6％（54/509）中报告了瘘管，最常见的是肛周瘘（27.8%[15/54]），其次是肠外瘘（16.8%[9/54]），肠瘘（16.8%[9/54]）。此外,7.4%(41/557)的IBD患者在横断面成像上发现有EIM，最普遍的EIM是胆石症(63.4%[26/41])，其次是骶髂关节炎(24.4%[10/41])，原发性硬化性胆管炎(4.8%[2/41])和肾结石(4.8%[2/41])。
结论：大约40%接受横断面成像的CD患者有狭窄或造瘘的证据，7%的IBD患者具有可检测的EIM。这些结果突出了疾病的负担和对这些疾病表型的特定疗法的需要。
方法：在伦敦的两个三级护理中心进行的回顾性研究，安大略省。纳入在2010年1月1日至2018年12月31日期间接受CT小肠造影（CTE）或MR小肠造影（MRE）的确诊为IBD的患者（≥18岁）。分类变量报告为比例,并且报告连续变量的平均值和标准偏差。
结果：557例IBD患者共进行了615次影像学检查（MRE：67.3％[414/615]）（CD：91.4％[509/557]，UC:8.6%[48/557])。38.2%(213/557)的患者为男性,平均年龄45.6岁（±15.8），中位病程为11.0年（±12.5）。在CD患者中，33.2%(169/509)有狭窄，7.8%有两个或两个以上狭窄，66.3%认为是炎症。在10.6％（54/509）中报告了瘘管，最常见的是肛周瘘（27.8%[15/54]），其次是肠外瘘（16.8%[9/54]），肠瘘（16.8%[9/54]）。此外,7.4%(41/557)的IBD患者在横断面成像上发现有EIM，最普遍的EIM是胆石症(63.4%[26/41])，其次是骶髂关节炎(24.4%[10/41])，原发性硬化性胆管炎(4.8%[2/41])和肾结石(4.8%[2/41])。
结论：大约40%接受横断面成像的CD患者有狭窄或造瘘的证据，7%的IBD患者具有可检测的EIM。这些结果突出了疾病的负担和对这些疾病表型的特定疗法的需要。
