Effect of structured report on the diagnosis of Crohn’s disease by CT enterography
NI Genghuan1 JIA Yuzhu2 AO Weiqun2 LYU Haijuan1 PAN Hao1 SHEN Haiyan3 ▲
1.Department of Radiology, the Second Affiliated Hospital of Jiaxing University, Zhejiang Province, Jiaxing 314000, China;
2.Department of Radiology, Tongde Hospital of Zhejiang Province, Zhejiang Province, Hangzhou 310000, China;
3.Depart- ment of Gastroenterology, the Second Affiliated Hospital of Jiaxing University, Zhejiang Province, Jiaxing 314000, China
Abstract：Objective To explore the effect of structured report (SR) on the diagnosis of Crohn’s disease (CD) by CT enterography (CTE). Methods A retrospective study was conducted on 223 suspected or confirmed CD patients who underwent both CTE and endoscopic examinations at the Second Affiliated Hospital of Jiaxing University, Zhejiang Province from March 2020 to October 2021. According to the CTE report format, they were divided into SR group (103 cases) and narrative report (NR) group (120 cases). The sensitivity, specificity, negative predictive value, and positive predictive value of CTE reports were compared between two groups using colonoscopy or capsule endoscopy and pathological results as the gold standard; the CTE comprehensive score and Crohn’s disease activity index (CDAI) score reported were compared between two groups, and the correlation between CTE score and CDAI score was analyzed; in the two groups, 25 reports were selected by drawing lots, and the frequency of keyword occurrence was counted; and a questionnaire survey was conducted among seven clinicians to compare their satisfaction with two reporting modes. Results The sensitivity, specificity, positive predictive value, and negative predictive value of CD diagnosis in SR group were higher than those in NR group, and the differences were statistically significant (P＜0.05). There was no significant difference in CDAI score between two groups (P＞0.05); the CTE score in SR group was higher than that in NR group, and the difference was statistically significant (P＜0.05). CTE scores in SR and NR were positively correlated with CDAI scores (r=0.884, 0.651, P＜0.05). The most frequent occurrence of SR was the location of disease, the pattern of enhancement, the density of plain scan, the degree of enhancement after enhancement (arterial stage), and the degree of enhancement after enhancement (venous stage), and followed by the thickening, and thickening degree of intestinal disease; the highest frequency of NR occurred in the site of disease, followed by the enhancement mode. The total satisfaction score of SR was higher than NR, and the difference was statistically significant (P＜0.05). Conclusion SR can effectively improve the diagnostic efficiency of CTE for CD, reduce the risk of missed diagnosis and misdiagnosis, and provide accurate and efficient evaluation for clinic.
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