Magnetic resonance enterography for assessment of intestinal graft-versus-host disease after allogeneic stem cell transplantation

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• 作者：Thorsten Derlin ; Azien Laqmani ; Simon Veldhoen ; Ivayla Apostolova…
• 关键词：MRI ; Small bowel ; Large bowel ; Graft ; versus ; host ; disease ; Stem cell transplantation
• 刊名：European Radiology
• 出版年：2015
• 出版时间：May 2015
• 年：2015
• 卷：25
• 期：5
• 页码：1229-1237
• 全文大小：569 KB
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• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Imaging and Radiology
  Diagnostic Radiology
  Interventional Radiology
  Neuroradiology
  Ultrasound
  Internal Medicine
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1432-1084

文摘

Objectives To determine the diagnostic performance of MR enterography (MRE) for detection and grading of gastrointestinal graft-versus-host disease (GI GvHD) after hematopoietic stem cell transplantation (SCT). Methods Forty-one patients with known GvHD or suspected GvHD underwent MRE and GI endoscopy with multi-level biopsies. MRE images were reviewed for presence of intestinal wall inflammation. Clinical grading of GI GvHD was performed. Histopathological evaluation (HPE) served as the reference standard. Results Overall, MRE demonstrated a per-patient sensitivity of 81.5?% for detection of GI GvHD. The most common findings were intestinal wall thickening (81.5?% of GvHD patients), luminal stenosis (81.5?%), mural contrast enhancement (70.4?%), and ascites (59.3?%). These findings were also observed in other conditions than GvHD. The most frequently involved intestinal segment was the sigmoid colon (63.0?%), followed by the ileum (59.3?%) and the jejeunum (51.9?%). The number of involved segments (r s =0.54, p =0.009) correlated significantly with clinical severity as determined by GvHD grading. Conclusions After allogeneic stem cell transplantation, MRE may (1) contribute to detection and localization of GI GvHD, and (2) add information indicating the clinical severity of disease, but findings are unspecific. False negative results may be observed not only in low-grade GI GvHD. Key Points -Magnetic resonance enterography (MRE) allows for detection of GI GvHD -Common findings are wall thickening, stenosis, mural contrast enhancement, and ascites -The extent of GI involvement on MRE correlates with clinical severity of GvHD -Involvement of sigmoid colon and small intestine is common -Findings are unspecific and also observed in other conditions, e.g. infectious enteritis