CT Scoring System for the Assessment of Systemic Lupus Erythematosus Associated Gastrointestinal Involvement: A Single-center Retrospective Study

  Objective  The aim of this study was to develop a CT image-based evaluation system for systemic lupus erythematosus(SLE)associated with gastrointestinal involvement.

  Methods  The clinical data of SLE patients with gastrointestinal(GI) involvement from September 2013 to May 2018 were retrospectively analyzed. The bowel wall thickness and extra-GI organs involvement were recorded by CT imaging. A new CT scoring system was established. Then the relationship between the CT score and the time to GI functional recovery, the length of hospital stay, the systemic lupus erythematosus disease activity index (SLEDAI), and laboratory findingswere analyzed.

  Results  A total of 63 SLE patients with GI involvement were enrolled, including 60 females and 3 males with a mean age of (36.7±13.1)years and SLE duration of 4 (1-8) years; 54 patients (85.7%, 54/63) had GI tract thickness/edema; 31 patients (49.2%, 31/63) had extra-GI involvement; the average intestinal wall thickness was (7.8±3.7)mm. CT score was positively correlated with the time of GI functional recovery (r=0.365, P=0.003). Compared to those with a CT score >2, patients with a CT score ≤ 2 had a shorter time of GI recovery(7.9±6.2)d vs. (15.8±13.8)d, P=0.006), a shorter length of hospital day(17.1±9.0)d vs. (25.7±20.5)d, P=0.043), a lower SLEDAI(7.6±4.4 vs. 12.2±7.2, P=0.004); and were less likely to receive higher dose of corticosteroids (60.7% vs. 88.6%, P=0.010).

  Conclusion  The CT scoring system can be used to assess the severity of SLE in patients with GI involvement.