Validation of a Simple Ultrasound Score for Crohn’s Disease
In a prospective multicenter study, investigators validated a simplified intestinal ultrasound (IUS) scoring system for evaluating Crohn’s disease (CD) activity, comparing findings against ileocolonoscopy as the reference standard.
A total of 107 patients with CD underwent both ultrasound and ileocolonoscopy, with disease activity graded using the Simple Endoscopic Score for Crohn’s Disease (SES-CD). Ultrasound predictors of disease severity included bowel wall thickness and color Doppler grade. Interobserver agreement was excellent for both parameters, underscoring the reproducibility of the method.
Analysis of 126 intestinal segments demonstrated strong correlation between the simple US score and SES-CD (r = 0.757, P < .001). Using a cutoff of 3.1, the US score achieved high diagnostic accuracy for active disease, with an area under the receiver operating characteristic curve (ROC) of 0.979, sensitivity of 92.5%, and specificity of 100%. Results were consistent with the original development cohort, where a cutoff of 5.5 yielded sensitivity of 90% and specificity of 86.4% (ROC 0.923).
The score also showed utility in identifying severe disease characterized by ulceration. At a cutoff of 7, the ROC was 0.853, with sensitivity of 0.73 and specificity of 0.81. These findings indicate the score’s ability not only to detect active inflammation but also to stratify disease severity.
This study validates this simplified IUS score as a reliable and accurate tool for assessing Crohn’s disease activity. The score correlates strongly with endoscopic findings, demonstrates excellent reproducibility, and effectively distinguishes both active and severe disease, supporting its integration into clinical practice for noninvasive disease monitoring.
Reference:
Ripollés T, Poza J, Martínez-Pérez MJ, Suarez Ferrer C, Blanc E, Paredes JM. Evaluation of Crohn’s Disease activity: validation of a segmental simple ultrasound score in a multicenter study. Inflamm Bowel Dis. 2025;31(8):2081–2087. doi:10.1093/ibd/izae213.
