MR findings in patients with disabling musculocutaneous chronic graft-versus-host disease.
OBJECTIVE
To describe musculocutaneous MR-findings responsible for disability in chronic graft-versus-host disease (cGVHD) after allogeneic hematopoietic cell transplantation (HCT).


METHODS
Between June 2005 and February 2008, we performed whole-body musculoskeletal magnetic resonance imaging (MRI; n = 12) or regional MRI (n = 4) in 16 consecutive patients presenting with disabling sclerodermatous cGVHD (e.g., skin edema, fixed deep dermal sclerosis, joint contractures, painful muscular contractures, or myalgia).


RESULTS
In all patients, MRI showed musculocutaneous abnormalities reflecting different degrees of inflammation and collagen tissue involvement of the skin (n = 10), subcutaneous fat tissue (n = 13), muscle fasciae (n = 16), subfascial muscular septae (n = 6), or findings compatible with myositis (n = 3). The most frequently involved muscle fasciae comprised those of the vastus lateralis muscle (n = 12), biceps femoris muscle (n = 11), gastrocnemius medialis muscle (n = 8), serratus anterior muscle, and latissimus dorsi muscle (each, n = 5). Increased signal of involved tissues on STIR-images and fat-saturated postgadolinium T1-weighted images represented the most frequent MR-signal abnormalities.


CONCLUSIONS
MR imaging of musculocutaneous cGVHD allows accurate evaluation including assessment of deep tissue infiltration and assists in the differential diagnosis.
Horger
M
M
Department of Diagnostic Radiology, Eberhard-Karls-University, Hoppe-Seyler-Str.3, 72076, Tübingen, Germany. mshorger@med.uni-tuebingen.de
Boss
A
A
Bethge
W
W
Faul
C
C
Fierlbeck
G
G
Bornemann
A
A
Claussen
C D
CD
Vogel
W
W
D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D006086:Graft vs Host Disease / Q000175:diagnosis*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009135:Muscular Diseases / Q000175:diagnosis*; D012871:Skin Diseases / Q000175:diagnosis*; D051598:Whole Body Imaging