Development and validation of a CT algorithm for the identification of nonperforated duodenal bulb ulcer

作者全名："Gong, Jun-Wei; Zhang, Zhu; Luo, Tian-you; Huang, Xing -Tao; Huo, Ji -Wen; He, Xiao-Qun; Li, Qi"

作者地址："[Gong, Jun-Wei; Luo, Tian-you; Huo, Ji -Wen; He, Xiao-Qun; Li, Qi] Chongqing Med Univ, Affiliated Hosp 1, Dept Radiol, Chongqing 400016, Peoples R China; [Zhang, Zhu] Chongqing Med Univ, Affiliated Hosp 1, Dept Nucl Med, Chongqing 400016, Peoples R China; [Huang, Xing -Tao] Fifth Peoples Hosp Chongqing, Dept Radiol, Chongqing 400062, Peoples R China; [Li, Qi] Chongqing Med Univ, Affiliated Hosp 1, Dept Radiol, 1 Youyi Rd, Chongqing 400016, Peoples R China"

通信作者："Li, Q (通讯作者)，Chongqing Med Univ, Affiliated Hosp 1, Dept Radiol, 1 Youyi Rd, Chongqing 400016, Peoples R China."

来源：EUROPEAN JOURNAL OF RADIOLOGY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001009408200001

JCR分区：Q1

影响因子：3.3

年份：2023

卷号：162

期号：　

开始页：　

结束页：　

文献类型：Article

关键词：Duodenal bulb ulcer; Diagnosis; Computed tomography

摘要："Purpose: To assess the value of multiplanar computed tomography (CT) in the diagnosis of nonperforated duodenal bulb ulcer (NPDBU).Method: We retrospectively analyzed data from 135 patients with NPDBU (ulcer group) and 150 patients with a normal duodenal bulb (control group) who underwent contrast-enhanced abdominal CT and were diagnosed via upper endoscopy from January 2018 to February 2022. The clinical and CT features were compared between the two groups. Independent prognostic factors for diagnosing NPDBU were determined using binary logistic regression analysis. An external validation cohort to determine the model's efficiency comprised 80 patients from another center.Results: Gastrointestinal bleeding was more frequent in patients with NPDBU than in those without (p < 0.001). No significant differences in age and sex were observed between the groups (all p > 0.05). The duodenal bulbar wall was significantly thicker in the ulcer group than in the control group, as determined using CT (p < 0.001). Irregular mucosal surface, layered enhancement, and blurred fat space around the duodenal bulb were more common in the ulcer group than in the control group (allp < 0.001). Binary logistic regression analysis revealed that gastrointestinal bleeding, wall thickness of >= 4.85 mm, irregular mucosal surface, and blurred peripheral fat space were the most significant variations associated with NPDBU, with an area under the curve (AUC) of 0.974. The external validation cohort had an AUC of 0.916.Conclusions: Careful multiplanar CT interpretation suggests the underlying presence of NPDBU and allows timely endoscopic verification and appropriate treatment."

基金机构：Chongqing medical scientific research project (Joint project of Chongqing Health Commission and Science and Technology Bureau) [2022MSXM147]; Chongqing Health Commission (Chongqing Talent Program-Innovation leading Talent Research Project) of China [CQYC20210303348]

基金资助正文：This study was supported by Chongqing medical scientific research project (Joint project of Chongqing Health Commission and Science and Technology Bureau) (2022MSXM147) and Chongqing Health Commission (Chongqing Talent Program-Innovation leading Talent Research Project) (CQYC20210303348) of China.