Dear Editor,
We read with great interest the article by Dell’Era et al. entitled “Relevance of sonographic parameters for inflammatory bowel disease in children,” which concluded that parameters such as bowel wall thickness, mesentery hypertrophy, and altered echo pattern are independent predictors of inflammatory bowel disease (IBD) and that the combination of different ultrasound parameters is more accurate for the diagnosis [1].
First, we want to congratulate the authors because, based on their experience, they provide ultrasound tools that allow radiologists to recognize pathological findings and suspect the disease. This is important because IBD in children has been increasing over time and represents high costs for the system [2]. Therefore, a prompt diagnosis will positively impact patients’ quality of life and treatment.
However, there are matters we would like to discuss. First, it is challenging to discern between abnormal wall thickening and thickening due to poor distension of the bowel loops, which could lead to misdiagnosis, especially in non-expert eyes. Second, it’s crucial to note that sample size calculation was not performed; consequently, the confidence intervals for the odds ratios (OR) in both univariate and multivariate analyses are notably wide across many variables. This widening can likely be attributed to the limitations posed by insufficient sample size. Finally, it should be valuable to include if the bowel wall thickness is a variable that changes according to age, as many other measurements in pediatrics.
We would like to encourage other researchers to replicate this work across diverse populations, enhancing the robustness of these results and facilitating future meta-analysis.
Author contributions
Paula Andrea Forero, Andrés Felipe Herrera Ortiz, Andrés Vásquez Perdomo, and Nelson Bedoya, contributed to the conception, drafting, and critical revision of the manuscript. All authors approved the final version of the manuscript and agreed to be accountable for all aspects of the work.
Funding
The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.
Data availability
Not applicable.
Declarations
Conflict of interest
The authors have no relevant financial or non-financial interests to disclose.
Footnotes
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References
- 1.DellEra A, Cannatelli R, Ferretti F, Manzotti C, Dilillo D, Zuccotti G et al (2023) Relevance of sonographic parameters for inflammatory bowel disease in children. J Ultrasound. 26(4):815–22. 10.1007/s40477-023-00800-9 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Dillman JR, Smith EA, Sanchez RJ, DiPietro MA, DeMatos-Maillard V, Strouse PJ et al (2015) Pediatric small bowel Crohn’s disease: correlation of US and MR enterography. Radiographics [Internet]. 35(3):835–48. 10.1148/rg.2015140002 [DOI] [PMC free article] [PubMed] [Google Scholar]
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Data Availability Statement
Not applicable.