Although the landmark of Crohn’s Disease (CD) is the transmural inflammation, mucosal healing (MH), which is assessed by colonoscopy, is currently the gold standard of CD management. Transmural healing (TH) is a new concept evaluated by cross-sectional imaging (CSI) techniques, such as bowel ultrasound (US), computed tomography enterography (CTE) and magnetic resonance enterography (MRE). Little is known about the clinical significance of persisting mural disease and the predictive value of complete TH.
The authors reviewed the available literature on TH and its meaning as predictor of long-term outcomes in CD, to explore if TH may be a better target compared to MH in CD patients, in terms of disease outcome, such as medication changes, hospitalization or surgery.
Some evidence suggests that achieving TH has a predictive value in CD management and correlates with better disease outcome than MH, although existing studies are few and with limitations. A definitive definition of TH is not yet established and the frequency or the preferred modality of TH evaluation remain unclear. Implementing TH in treat-to-target approach may enable stricter disease monitoring with non-invasive methods and finally change the disease course, preventing irreversible bowel damage.
About The Expert
Eirini Zacharopoulou
Vincenzo Craviotto
Gionata Fiorino
Federica Furfaro
Alessandra Zilli
Daniela Gilardi
Laurent Peyrin-Biroulet
Silvio Danese
Mariangela Allocca
References
PubMed