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Background  Evaluate the possibility of CT enterography (CTE) score system as a predictor in assessing active ulcerative colitis (UC) severity.    Methods  Forty-six patients with active UC with CTE and colonoscopy were enrolled. Based on modified Mayo score, patients were divided into three groups: mild ( n  = 10), moderate ( n  = 17) and severe ( n  = 19). A cumulative CTE score was calculated in each patient and its correlation with modified Mayo score was analyzed. The optimal cutoff values of CTE score were determined by receiver operating characteristic (ROC) curves analysis.    Results  Significant between-group differences were observed in CTE spectrums of mucosal bubbles, mural stratification, loss of haustration, enlarged mesenteric lymph nodes and engorged mesenteric vessels ( P  < 0.05). The cumulative CTE scores were significant difference between three groups (CTE score:4.9 ± 2.3, 7.6 ± 2.6, and 10.9 ± 2.0, respectively,  P  < 0.01). The cumulative CTE score showed a positive correlation with modified Mayo score ( r  = 0.835,  P  < 0.05). The optimal cut-off value for CTE score predicting moderate and severe UC was 9.5 (area under the curve [AUC]:0.847, sensitivity:78.9%, specificity:82.4%).    Conclusion  Disease severity assessment by CTE score demonstrates strong positive correlation with severity established modified Mayo score. CTE score system maybe a potential predictor for active UC severity assessment.

CT Enterography score: a potential predictor for severity assessment of active ulcerative colitis