Introduction
Materials and methods
Clinical and SBCE data accumulation
SBCE assessment
Assessment of inter- and intra-observer agreement
Statistical analysis
Results
Patients
Comparison of SBCE findings between patients with and without CD
CD group | Non-CD group | p value | |
---|---|---|---|
Number of ulcer | 9 [2–20] | 2 [0–7] | 0.0001 |
Types of ulcer | |||
Oval | 18 (29%) | 14 (31%) | 0.83 |
Irregular | 53 (84%) | 27 (60%) | 0.0071 |
Longitudinal | 49 (78%) | 9 (20%) | < 0.0001 |
Circular | 12 (19%) | 8 (18%) | 1.0 |
Cobblestone appearance | 21 (33%) | 1 (2%) | < 0.0001 |
Number of erosion | 42 [18–93] | 8 [4–24.5] | < 0.0001 |
Types of erosion | |||
Oval | 47 (75%) | 32 (71%) | 0.83 |
Irregular | 56 (89%) | 29 (64%) | 0.0037 |
Linear | 57 (90%) | 17 (38%) | < 0.0001 |
Circular | 21 (33%) | 9 (20%) | 0.19 |
Alignment of diminutive lesions | |||
Longitudinal | 35 (56%) | 3 (7%) | < 0.0001 |
Circumferential | 47 (75%) | 4 (9%) | < 0.0001 |
Lewis score | 450 [225–1012] | 225 [68–525] | 0.0055 |
Bowel cleanliness score | 9 [8–10] | 9 [7–10.5] | 0.77 |
Comparison of SBCE findings among small bowel segments in patients with CD
1st tertile | 2nd tertile | 3rd tertile | |
---|---|---|---|
Presence of any ulcers | 29 (46%) | 32 (51%) | 51 (81%) |
Types of ulcer | |||
Oval | 6 (10%) | 7 (11%) | 15 (24%) |
Irregular | 24 (38%) | 30 (48%) | 46 (73%) |
Longitudinal | 16 (25%) | 25 (40%) | 44 (70%) |
Circular | 3 (5%) | 5 (8%) | 7 (11%) |
Cobblestone appearance | 8 (13%) | 12 (19%) | 11 (17%) |
Presence of any erosions | 52 (83%) | 58 (92%) | 61 (97%) |
Types of erosion | |||
Oval | 29 (46%) | 35 (56%) | 32 (51%) |
Irregular | 36 (57%) | 38 (60%) | 47 (75%) |
Linear | 38 (60%) | 39 (62%) | 46 (73%) |
Circular | 7 (11%) | 10 (16%) | 10 (16%) |
Alignment of diminutive lesions | |||
Longitudinal | 25 (40%) | 18 (29%) | 9 (14%) |
Circumferential | 32 (51%) | 24 (38%) | 10 (16%) |
Bowel cleanliness score | 4 [3, 4] | 3 [3, 4] | 2 [2, 3] |
Correlation between laboratory data and SBCE findings in patients with CD
Hematological parameter | Correlation coefficient (ρ) | |
---|---|---|
All (n = 63) | Ileitis only (n = 24) | |
White blood cell | − 0.0174 | − 0.0030 |
Hemoglobin | − 0.3274 | − 0.3763 |
Platelet | 0.30110 | 0.2628 |
Total protein | − 0.0340 | − 0.1212 |
Albumin | − 0.4814 | − 0.5343 |
C-reactive protein | 0.3566 | 0.2428 |
Inter- and intra-observer variations
SBCE findings | Inter-observer agreementa | Intra-observer agreementa | ||
---|---|---|---|---|
Observer 1 | Observer 2 | Observer 3 | Expert endoscopist | |
Ulcer | ||||
Oval | − 0.004 (− 0.22–0.22) | 0.51 (0.26–0.77) | 0.05 (− 0.23–0.33) | 0.32 (0.04–0.59) |
Irregular | 0.35 (0.15–0.55) | 0.64 (0.42–0.87) | 0.62 (0.40–0.84) | 0.53 (0.27–0.78) |
Longitudinal | 0.05 (− 0.04–0.14) | 0.34 (0.09–0.59) | 0.59 (0.37–0.80) | 0.76 (0.58–0.94) |
Circular | 0.31 (0.03–0.58) | 0.43 (0.14–0.72) | 0.54 (0.26–0.82) | 0.63 (0.38–0.88) |
Cobblestone appearance | 0.50 (0.16–0.85) | 0.50 (0.16–0.85) | 0.47 (0.21–0.73) | 0.83 (0.61–1) |
Erosion | ||||
Oval | 0.07 (− 0.12–0.26) | 0.19 (− 0.11–0.49) | − 0.12 (− 0.34–0.10) | 0.42 (0.10–0.73) |
Irregular | 0.30 (− 0.01–0.61) | 0.25 (− 0.05–0.55) | 0.38 (0.09–0.66) | 0.49 (0.21–0.78) |
Linear | 0.07 (− 0.09–0.22) | 0.17 (− 0.03–0.38) | 0.38 (0.10–0.66) | 0.57 (0.35–0.80) |
Circular | 0.25 (− 0.02–0.53) | 0.29 (0.03–0.56) | 0.44 (0.17–0.72) | 0.49 (0.21–0.75) |
Alignment of diminutive lesions | ||||
Longitudinal | 0.14 (− 0.04–0.31) | 0.44 (0.19–0.69) | 0.57 (0.36–0.78) | 0.74 (0.54–0.93) |
Circumferential | 0.30 (0.08–0.53) | 0.32 (0.07–0.58) | 0.45 (0.21–0.69) | 0.72 (0.53–0.91) |
Diagnostic accuracy of SBCE findings for CD
SBCE findings | Sensitivity (%) | Specificity (%) | PPV (%) | NPV (%) |
---|---|---|---|---|
Longitudinal ulcer or cobblestone appearance | 77 | 80 | 84 | 72 |
Linear erosion | 90 | 62 | 77 | 82 |
Lesion alignment only | ||||
Longitudinal | 56 | 93 | 92 | 60 |
Circumferential | 75 | 91 | 92 | 72 |
Longitudinal or circumferential | 79 | 87 | 89 | 75 |
Linear erosion plus lesion alignment | ||||
Longitudinal | 54 | 91 | 89 | 59 |
Circumferential | 71 | 93 | 94 | 70 |
Longitudinal or circumferential | 75 | 87 | 89 | 71 |