Objective To explore the correlation between the main imaging features of CT enterography (CTE) and endoscopic inflammatory activity of Crohn′s disease (CD).

Methods The CTE data of 160 patients diagnosed with Crohn′s disease were collected, and the endoscopic and clinical data were retrospectively analyzed. CTE parameters associated with CD activation included intestinal wall thickening and enhancement, intestinal wall stratification, abdominal lymphadenopathy, changes in mesenteric fat density, combing signs, and complications (stenosis, fistula, and abscess). The CD simplified endoscopic score (SES-CD) was used to evaluate the endoscopic inflammatory activity of CD. Multivariate Logistic regression analysis was used to evaluate the risk factors of endoscopic inflammatory activity of CD patients. The receiver operating characteristic (ROC) curve was used to analyze the value of the above indicators alone and their combination for evaluation of endoscopic CD activity.

Results SES-CD was positively correlated with mural thickness, mural hyperenhancement, mural stratification and mesenteric fat densification(P < 0.05). Multivariate Logistic regression analysis showed that severe intestinal wall thickening (OR=5.695, 95%CI, 1.294 to 25.064, P=0.021), intestinal wall enhancement (OR=1.033, 95%CI, 1.007 to 1.060, P=0.014), dense mesenteric fat density (OR=5.748, 95%CI, 2.364 to 13.980, P < 0.05) were risk factors for inflammatory activity in CD patients. The receiver operating characteristic (ROC) curve showed that the sensitivity, specificity of intestinal wall thickening, intestinal wall enhancement and mesenteric fat densification in combination in evaluating CD endoscopic CD activity were 75.7%, 73.3%, respectively, and area under the curve (AUC) was 0.803 (P < 0.05).

Conclusion The CTE signs (bowel wall thickness, bowel wall hyperenhancement and mesenteric fat densification) are strongly correlated with SES-CD. Their combination is helpful to assess the inflammatory activity under CD endoscopy.