Degree of Creeping Fat Assessed by CT Enterography is Associated with Intestinal Fibrotic Stricture in Patients with Crohn's Disease: A Potentially Novel Mesenteric Creeping Fat Index.

Li, Xue-Hua, Feng, Shi-Ting, Cao, Qing-Hua, Coffey, J Calvin, Baker, Mark E, Huang, Li, Fang, Zhuang-Nian, Qiu, Yun, Lu, Bao-Lan, Chen, Zhi-Hui, Li, Yi, Bettenworth, Dominik, Iacucci, Marietta, Sun, Can-Hui, Ghosh, Subrata, Rieder, Florian, Chen, Min-Hu, Li, Zi-Ping and Mao, Ren (2021) Degree of Creeping Fat Assessed by CT Enterography is Associated with Intestinal Fibrotic Stricture in Patients with Crohn's Disease: A Potentially Novel Mesenteric Creeping Fat Index. Journal of Crohn's & colitis. ISSN 1876-4479.

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Abstract

BACKGROUND AND AIMS

Emerging evidence points to a link between creeping fat and pathogenesis of Crohn's disease (CD). Non-invasive assessment of the severity of creeping fat on cross-sectional imaging modality has seldom been investigated. This study aimed to develop and characterize a novel mesenteric creeping fat index (MCFI) based on CT in CD patients.

METHODS

MCFI was developed based on vascular findings on CT in retrospective cohort (n=91) and validated in prospective cohort (n=30). The severity of creeping fat was graded based on the extent to which mesenteric fat extended around the intestinal circumference using the vessels in the fat as a marker. The accuracy of MCFI was assessed by comparing it with the degree of creeping fat observed in surgical specimens. The relationship between MCFI and fibrostenosis was characterized by determining if these correlated. The accuracy of MCFI was compared with other radiographic indices (i.e. visceral to subcutaneous fat area ratio and fibrofatty proliferation score).

RESULTS

In retrospective cohort, MCFI had moderate accuracy in differentiating moderate-severe from mild fibrostenosis (AUC=0.799; P=0.000). ROC analysis in retrospective cohort identified a threshold MCFI of >3 which accurately differentiated fibrostenosis severity in prospective cohort (AUC=0.756; P=0.018). Excellent correlation was shown between MCFI and the extent of fat wrapping in specimens in prospective cohort (r=0.840, P=0.000). Neither visceral to subcutaneous fat area ratio nor fibrofatty proliferation score correlated well with intestinal fibrosis degree.

CONCLUSIONS

MCFI can accurately characterize the extent of mesenteric fat wrapping in surgical specimens. It may become another non-invasive measure of CD fibrostenosis.

Item Type: Article
Subjects: WI Digestive system. Gastroenterology
Divisions: Planned IP Care > Gastroentrology
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Depositing User: Mrs Yolande Brookes
Date Deposited: 08 Jan 2021 17:01
Last Modified: 08 Jan 2021 17:01
URI: http://www.repository.uhblibrary.co.uk/id/eprint/3827

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