Comment on “Ultrasonographic scores for ileal Crohn’s disease assessment: better, worse or the same as contrast-enhanced ultrasound?”

We read with interest the study by Freitas et al. comparing contrast-enhanced ultrasound (CEUS) and parameters from a time-intensity curve (TIC) with the SUS-CD score and IBUS-SAS score in patients with Crohn’s disease (CD) undergoing gastrointestinal ultrasound (GIUS) and ileocolonoscopy. The aim was to compare the accuracy of CEUS and aforementioned scores in predicting terminal ileal inflammatory activity in patients with CD. In this retrospective study of 50 patients, inflammatory activity was defined as a segmental score of SES-CD ≥ 7 in the terminal ileum. The study found 30 patients with active endoscopic disease demonstrating no significant difference between the “inactive” and “active” SUS CD and IBUS-SAS scores. However, the CEUS peak enhancement derived from the TIC was shown to be significantly different. The authors conclude CEUS was superior for detecting inflammation in the terminal ileum, as opposed to ultrasound scores relying on bowel wall thickness and color Doppler.