Gastroenterology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
Inflammatory Bowel Disease Center, University of Chicago Medicine, Chicago, Illinois, USA.
Am J Gastroenterol. 2023 Jun 1;118(6):961-969. doi: 10.14309/ajg.0000000000002265. Epub 2023 Mar 28.
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.
克罗恩病(CD)的治疗靶点在过去几十年中发生了很大的变化,包括内镜改善和临床缓解。然而,CD 的特征是贯穿肠壁的损伤,并且有越来越多的证据表明,贯穿肠壁愈合与改善的结果相关。肠超声是一种非侵入性、高度准确的成像方式,可提供实时结果,并可评估 CD 的贯穿肠壁愈合情况。在这篇综述中,我们介绍了超声对贯穿肠壁愈合的定义,它与其他成像方式和内镜的比较,不同治疗方法对实现贯穿肠壁愈合的疗效,以及在实现贯穿肠壁愈合的患者中的数据。这篇综述可以指导治疗炎症性肠病患者的临床医生,了解实现贯穿肠壁愈合的附加价值,并最终将其纳入治疗目标。