Ultrasonographic Transmural Healing in Crohn's Disease

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.