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BACKGROUND: Fewstudies have correlated computed tomography (CT) enterography findings withendoscopic severity and C reactive protein (CRP) concentrations. AIM: Toexamine whether small bowel inflammation at CT enterography correlates withendoscopic severity and CRP in patients with Crohn's disease (CD). METHODS: CTenterography datasets from 143 CD patients undergoing ileoscopy were examinedfor three different CT parameters: CT bowel enhancement, as defined by theratio of terminal ileal versus control ileal loop attenuation; vascularenlargement of the vasa recta ("the comb sign"); and mesenteric fatdensity. Correlations between CT scan parameters, endoscopy, and histologyseverity scores, and CRP were assessed using Spearman's rank correlation andlogistic regression. RESULTS: Endoscopic score was significantly correlatedwith CT bowel enhancement, comb sign, and fat density (Spearman correlationcoefficients 0.33-0.39; p<0.001). Correlations with histologicalinflammation were strongest for bowel enhancement (r = 0.34-0.38; p<0.001).CRP was elevated in patients with increased fat density versus those withincreased bowel enhancement only (median 0.96 v 0.23, p = 0.002). CRP did notdiffer significantly between patients without evidence of active Crohn's andthose with bowel enhancement and endoscopic inflammation not involving theperienteric tissues by CT (median 0.24 v 0.36; p = 0.38). CONCLUSION:Quantitative measures of bowel enhancement at CT enterography correlate withendoscopic and histological severity. CRP correlates with radiological findingsof perienteric inflammation (increased fat density), but not of inflammationlimited to the small bowel wall, underscoring the potential role of perientericinflammation in CRP response in CD. Leggil'articolo