- 作者：Emma Calabrese ; Francesca Zorzi ; Emanuela Visconti ; Gottardo De Angelis ; Raffaella Cerretti ; Giovanna Del Vecchio Blanco ; Aless ; ra Picardi ; Laura Cudillo ; Massimiliano Postorino ; Luca Franceschini ; Livia Biancone ; William Arcese ; Francesco Pallone
- 关键词：Accuracy ; Endoscopy ; Graft versus host disease ; Sensitivity ; Specificity ; Ultrasonography
- 刊名：Digestive and Liver Disease
- 出版年：2013
- 出版时间：November, 2013
- 年：2013
- 卷：45
- 期：11
- 页码：899-904
- 全文大小：1553 K
Objective
Aim of our prospective study was to investigate accuracy of bowel ultrasonography in detecting gastrointestinal acute graft versus host disease (GVHD), when using clinical assessment as gold standard. In a subgroup of patients, bowel ultrasonography was compared with colonoscopy and histology in diagnosing of gastrointestinal acute GVHD.Methods
Fifty-two patients underwent allogeneic hematopoietic stem cell transplantation and developed gastrointestinal symptoms.
Results
Clinical assessment lead to a diagnosis of gastrointestinal acute GVHD in 17/52 patients, no gastrointestinal acute GVHD was detected in 20/52 patients, while 15 patients were not able to complete the study. Bowel ultrasonography detected either bowel wall thickness of the ileum and the colon or dilation in 16/17 patients and showed 94 % sensitivity (95 % CI 0.69-0.99), 95 % specificity (95 % CI 0.73-0.99), and 94.5 % accuracy. Colonoscopy was performed in 13/52 patients, showing gastrointestinal acute GVHD in 11/13. In these 11 patients, histology confirmed the diagnosis of gastrointestinal acute GVHD, and bowel ultrasonography detected findings compatible with gastrointestinal acute GVHD in all 11 patients, and was negative in the 2 patients with no gastrointestinal acute GVHD.
Conclusion
Bowel ultrasonography can be considered a valuable tool to add to clinical assessment for patients with suspected gastrointestinal acute GVHD for addressing a prompt and appropriate treatment.