Ultrasound criteria for transmural healing and response in Crohn's disease: a systematic review of definitions and thresholds.
Inflamm Bowel DisSep 1, 2026
Joëlle St-Pierre, Maxime Delisle, Yusuke Miyatani et al.
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In 30 seconds
This systematic review evaluated definitions of transmural healing (TMH) and transmural response (TMR) in Crohn's disease, analyzing 83 studies involving 8033 patients. It found that 79% of TMH definitions included bowel-wall thickness ≤3mm, while TMR definitions varied in thresholds for bowel-wall thickness reduction. The study highlights the need for standardized ultrasound criteria.
Key findings
- 79% of TMH definitions included bowel-wall thickness ≤3mm.
- 73% of TMR definitions required bowel-wall thickness reduction of ≥1 mm or ≥25%.
- 41% of TMR definitions also required improvement in Doppler flow.
- Pediatric-specific criteria were reported in only 2 TMH and 1 TMR studies.
Why it matters
Establishing standardized ultrasound criteria for TMH and TMR is crucial for improving the management of Crohn's disease. Consistent definitions can enhance the reliability of ultrasound assessments and support treatment strategies aimed at achieving remission.