Abstract Background Intestinal ultrasound (IUS) is a non-invasive, bed-side imaging tool increasingly used for monitoring treatment response in patients with Crohn’s disease (CD). Our goal was to assess changes in IUS parameters and their correlation with clinical, laboratory and endoscopic findings at diagnosis and within one year after diagnosis. Methods This retrospective study included children with CD diagnosed between 2017–2025. IUS was performed at diagnosis and every three months for one year. Parameters assessed included terminal ileum wall thickness (Ti-WT), Limberg score (LS), mesenteric fat, and lymphadenopathy. IUS findings were correlated with endoscopic score (SES-CD), Pediatric Crohn’s disease Activity Index (PCDAI), and laboratory biomarkers (CRP and fecal calprotectin). Results Thirty-two patients (20 males; 63%) with a median age of 12. 5 years (IQR 11. 0–15. 0) were included. All patients had terminal ileum involvement (L1 Paris classification in 18 56%). A total of 83 IUS were performed during the study period. At baseline, the median PCDAI, CRP, fecal calprotectin, SES-CD, Ti-WT and LS were 27. 5 (17. 5-34. 0), 2. 0 (0. 4–6. 7) mg, 1104 (611–3237) mcg/g, 8. 0 (5. 3–9. 7), 4. 5 (3. 5–6. 0) mm and 3 (3–4), respectively. At diagnosis, TI-WT showed the highest correlation with SES-CD (R = 0. 68), compared to PCDAI, CRP, FC and LS (R = 0. 28, 0. 55, -0. 45, 0. 47, respestively) (Figure 1). Normalization of the Limberg score and Ti-WT occurred in 12/32 (38%) and 15/32 (47%) patients. Time to normalization of disease activity indices was 5. 0 (3. 0-8. 7), 5. 0 (3. 0-8. 1), 8. 0 (5. 0-10. 0), 9. 1 (5. 3-11. 0) and 7. 1 (5. 0-9. 8) months for PCDAI, CRP, FC, LS and Ti-WT, respectively. Conclusion IUS parameters are highly associated with SES-CD at diagnosis. Improvement and normalization of IUS parameters are correlated with improvement of disease activity and laboratory biomarkers supporting the use of IUS as a non-invasive tool for monitoring treatment response in pediatric CD. Conflict of interest: Grabovski, Rinat: No conflict of interest Tal-Shifman, Noa: No conflict of interest Weintraub, Yael: No conflict of interest Shamir, Raanan: No conflict of interest Shouval, Dror: No conflict of interest Dr. Matar, Manar: No conflict of interest
Grabovski et al. (Thu,) studied this question.