What question did this study set out to answer?

The study aims to evaluate how well hyperechoic mesenteric fat detected by ultrasound can predict early recurrence after surgery in Crohn’s disease patients.

April 18, 2026Insights into Imaging0 citationsOpen Access

Hyperechoic mesenteric fat on preoperative intestinal ultrasound predicts early postoperative recurrence in Crohn’s disease

ZLZhuohua LiangSun Yat-sen University SCS ChenGuangdong Academy of Medical Sciences WCWenjie ChengSun Yat-sen University

Puntos clave

The study aims to evaluate how well hyperechoic mesenteric fat detected by ultrasound can predict early recurrence after surgery in Crohn’s disease patients.
Conducted a retrospective analysis of 124 Crohn’s disease patients who had intestinal resection.
Stratified patients into early postoperative recurrence (EPR) and non-EPR groups based on 1-year follow-up outcomes.
Compared clinical parameters and ultrasound findings between the two groups.
Used univariate and multivariate logistic regression to identify significant predictors of EPR.
EPR occurred in 59 patients (47.6%) within one year post-surgery.
Significant differences were found in clinical factors such as smoking history and levels of C-reactive protein and erythrocyte sedimentation rate.
Hyperechoic mesenteric fat showed superior predictive ability for EPR with an AUC of 0.808 compared to other indicators.
Hyperechoic mesenteric fat was confirmed as an independent predictor of EPR with an adjusted odds ratio of 18.810.

Resumen

Abstract Objective To investigate the value of hyperechoic mesenteric fat (HMF) detected by preoperative intestinal ultrasound (IUS) in predicting early postoperative recurrence (EPR) in patients with Crohn’s disease (CD). Materials and methods This retrospective study included 124 CD patients who underwent I-stage intestinal resection. Based on 1-year postoperative recurrence, patients were stratified into EPR ( n = 59) and non-EPR ( n = 65) groups. Clinical parameters (such as smoking history, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), immunosuppressive therapy) and IUS parameters (such as bowel wall thickness (BWT), HMF, abscess/fistula) were compared. Univariate and multivariate logistic regression identified EPR predictors. Results EPR occurred in 59 patients (47.6%) during the 1-year follow-up. Significant differences ( p < 0.05) were observed between EPR and non-EPR groups for clinical factors (smoking history, elevated preoperative CRP/ESR, postoperative immunosuppression) and IUS parameters (HMF, BWT, and abscess/fistula). HMF demonstrated superior discriminative capacity for EPR prediction (area under the curve (AUC) = 0.808, 95% confidence interval (CI): 0.728–0.873) vs BWT (AUC = 0.618, p < 0.05) and abscess/fistula (AUC = 0.599, p < 0.05). Univariate analysis identified CRP, ESR, colonic disease, immunosuppression, HMF, abscess/fistula, and BWT as candidate predictors ( p < 0.05), with multivariate analysis confirming HMF as an independent predictor (adjusted odds ratio (OR) = 18.810, 95% CI: 6.459–54.775; p < 0.001). Conclusions Preoperative IUS-detected HMF may serve as a valuable predictor for assessing EPR risk in patients with CD. Critical relevance statement Preoperative IUS identification of HMF provides a practical, non-invasive biomarker that enables radiologists to critically improve risk stratification for EPR in CD. Key Points EPR poses a significant clinical challenge in the management of CD. HMF detected on preoperative IUS is a strong, independent predictor for EPR, with superior predictive performance compared to other established IUS parameters. Assessing HMF provides a valuable, non-invasive imaging biomarker for preoperative risk stratification. Graphical Abstract

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