Ultrasonographic Transmural Healing in Crohn's Disease

Am J Gastroenterol. 2023 Jun 1;118(6):961-969.doi: 10.14309/ajg.0000000000002265. Epub 2023 Mar 28.


Francesca Zorzi 1David T Rubin 2Noa Krugliak Cleveland 2Giovanni Monteleone 1Emma Calabrese 1


Author information

1Gastroenterology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.

2Inflammatory Bowel Disease Center, University of Chicago Medicine, Chicago, Illinois, USA.


Therapeutic targets in Crohn's disease (CD) have evolved greatly over the past several decades to include endoscopic improvement along with clinical remission. Yet CD is characterized by transmural damage, and there is increasing evidence of improved outcomes associated with transmural healing. Intestinal ultrasonography is a noninvasive, highly accurate imaging modality that provides real-time results and can assess for transmural healing in CD. In this review, we present the definition of transmural healing by ultrasonography, its comparison with other imaging modalities and with endoscopy, the efficacy of diverse therapies on achieving transmural healing, and data on patient outcomes in those achieving transmural healing. This review can guide clinicians who care for patients with inflammatory bowel disease on the added value of achieving transmural healing and its eventual incorporation as a target of therapy.


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