Pilot case-control study to explore the value of intestinal ultrasound in the differentiation of two common diseases involving the ileocecal region: intestinal Behcet's disease and Crohn's disease

Background: Intestinal Behcet's disease (BD) and Crohn's disease (CD) are two diseases that commonly involve the ileocecal region and are difficult to differentiate. We aimed to investigate the value of intestinal ultrasound (IUS) in differentiating between these diseases. Methods: In this case-control study, patients diagnosed with intestinal BD or CD in the ileocecal region involved were recruited. The IUS characteristics of the two disease groups in terms of disease location, ileocecal region characteristics, and complications were compared. The differences were analyzed using univariate and multivariate analyses. Results: We consecutively enrolled 22 intestinal BD and 44 age- and sex-matched CD patients. On univariate analysis, focal lesion, ileocecal region involvement only, presence of ulcers on ultrasound (US), large ulcers (>2 cm) on US, and fistulas were significantly more common in intestinal BD than in CD, whereas small intestine involvement was significantly more common in CD. On multivariate analysis, focal lesion [odds ratio (OR) 0.156, 95% confidence interval (CI): 0.043-0.564], and large ulcers (OR 0.056, 95% CI: 0.006-0.550) were independent predictors of intestinal BD over CD. The area under the curve for the receiver-operating characteristic was 0.808 (95% CI: 0.706-0.929), and the sensitivity and specificity with a cutoff value of 0.7 were 75.0% and 77.3%, respectively. Conclusions: IUS can provide useful information for the differential diagnosis of intestinal BD and CD.