Abstract Background Ultrasound (US) is a widely accessible and fast imaging modality, however, it has diagnostic limitations, particularly in differentiating and characterising pathological lesions. The use of contrast agents significantly increases diagnostic accuracy and enables more precise evaluation within a single examination. The benefits of contrast-enhanced ultrasound (CEUS) have been demonstrated over the years not only in hepatic disorders but also in extrahepatic indications. The aim of the study was to compare the diagnostic performance of CEUS and magnetic resonance enterography (MRE) in patients with Crohn’s disease, as well as to assess the relationship between both imaging methods and clinical disease activity. Methods Between 2024 and 2025, 31 patients aged over 18 years with established Crohn’s disease (CD) who required clinically indicated MRE were prospectively enrolled. All patients additionally underwent CEUS examination. Clinical disease activity was quantified using the Crohn’s Disease Activity Index (CDAI) and the Harvey–Bradshaw Index (HBI). Ten quantitative CEUS parameters were analysed. MR enterography activity was evaluated using the Magnetic Resonance Index of Activity (MaRIA) and the Simple Enterographic Activity Score for Crohn’s Disease (SEAS-CD). Results A statistically significant strong correlation was observed between clinical disease activity assessed using CDAI and CEUS parameters, including bowel wall thickness (r = 0.707; p 0.001), the length of inflamed small bowel segment (r = 0.519; p = 0.007), and contrast enhancement pattern (r=-0.450; p = 0.014). HBI correlated significantly with CEUS-assessed small bowel wall thickness (r = 0.561; p = 0.004) and Limberg score (r = 0.395; p = 0.046). Faecal calprotectin showed significant correlation with bowel wall thickness (r = 0.572; p = 0.016), while C-reactive protein correlated with inflamed bowel segment length (r = 0.456; p = 0.019) and vascularity type (r = 0.386; p = 0.047). MaRIA score correlated significantly only with HBI (r = 0.371; p = 0.047) and CEUS-assessed vascularity (r = 0.398; p = 0.040). SEAS-CD showed no significant correlation with CDAI, HBI or inflammatory biomarkers; however, it correlated with CEUS vascularity type (r = 0.511; p = 0.006) and contrast enhancement pattern (r = 0.410; p = 0.030). Conclusion CEUS parameters correlate with clinical disease activity measures and MR enterography findings in patients with Crohn’s disease. CEUS may be effectively used as a diagnostic and treatment-monitoring modality in Crohn’s disease. Conflict of interest: Dr. Sobolewska-Wlodarczyk, Aleksandra: No conflict of interest Majos, Marcin: No conflict of interest Hołdrowicz, Mateusz: No conflict of interest Majos, Agat: No conflict of interest Gasiorowska, Anita: No conflict of interest
Sobolewska-Włodarczyk et al. (Thu,) studied this question.