title: Ultrasonographic evaluation of gastrointestinal graft-versus-host disease after hematopoietic stem cell transplantation.
abstract: Gastrointestinal graft-versus-host disease (GI-GVHD) is a major and life-threatening complication of hematopoietic stem cell transplantation (HSCT). This study evaluated the efficacy of ultrasonography (US) for assessing and monitoring GI-GVHD. GI tract was evaluated by US in 81 patients. US findings were positive in 43 patients, including 11 false positive, and negative in 38 patients. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of US for the diagnosis of GI-GVHD were 100%, 78%, 74%, 100%, and 86%, respectively. Diffuse wall thickening of the ileum was the most frequent finding in patients with GI-GVHD. Severity of GI-GVHD was correlated with the thickness of internal low echoic layer of the wall, the echogenicity of mesenteric fat tissue, and the intensity of Doppler signaling. We classified US findings of GI-GVHD into four US grades. There was a significant correlation between clinical stage of GI-GVHD and the US grade. These ultrasonographic abnormalities were improved with clinical improvement of GI-GVHD upon treatment. Thus, US is an effective and efficient non-invasive means of identifying the extent and severity of GI-GVHD and monitoring response to treatment.
authors.affiliation: Division of Laboratory and Transfusion Medicine, Hokkaido University Hospital, Sapporo, Japan.|Diagnostic Center for Sonography, Hokkaido University Hospital, Sapporo, Japan.
authors.forename: Mutsumi
authors.initials: M
authors.lastname: Nishida
authors.affiliation: Division of Laboratory and Transfusion Medicine, Hokkaido University Hospital, Sapporo, Japan.|Department of Hematology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
authors.forename: Akio
authors.initials: A
authors.lastname: Shigematsu
authors.affiliation: Diagnostic Center for Sonography, Hokkaido University Hospital, Sapporo, Japan.|Department of Radiological Technology, Hokkaido University Hospital, Sapporo, Japan.
authors.forename: Megumi
authors.initials: M
authors.lastname: Sato
authors.affiliation: Division of Laboratory and Transfusion Medicine, Hokkaido University Hospital, Sapporo, Japan.|Diagnostic Center for Sonography, Hokkaido University Hospital, Sapporo, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Kudo
authors.affiliation: Division of Laboratory and Transfusion Medicine, Hokkaido University Hospital, Sapporo, Japan.|Diagnostic Center for Sonography, Hokkaido University Hospital, Sapporo, Japan.
authors.forename: Satomi
authors.initials: S
authors.lastname: Omotehara
authors.affiliation: Diagnostic Center for Sonography, Hokkaido University Hospital, Sapporo, Japan.|Department of Radiological Technology, Hokkaido University Hospital, Sapporo, Japan.
authors.forename: Tatsunori
authors.initials: T
authors.lastname: Horie
authors.affiliation: Division of Laboratory and Transfusion Medicine, Hokkaido University Hospital, Sapporo, Japan.|Diagnostic Center for Sonography, Hokkaido University Hospital, Sapporo, Japan.
authors.forename: Takahito
authors.initials: T
authors.lastname: Iwai
authors.affiliation: Department of Hematology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Endo
authors.affiliation: Department of Pediatrics, Hokkaido University Hospital, Sapporo, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Iguchi
authors.affiliation: Division of Laboratory and Transfusion Medicine, Hokkaido University Hospital, Sapporo, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Shibuya
authors.affiliation: Department of Surgical Pathology, Hokkaido University Hospital, Sapporo, Japan.
authors.forename: Kanako
authors.initials: K
authors.lastname: Hatanaka
authors.affiliation: Division of Laboratory and Transfusion Medicine, Hokkaido University Hospital, Sapporo, Japan.
authors.forename: Chikara
authors.initials: C
authors.lastname: Shimizu
authors.affiliation: Department of Hematology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
authors.forename: Takanori
authors.initials: T
authors.lastname: Teshima
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D005767:Gastrointestinal Diseases / Q000000981:diagnostic imaging* / Q000209:etiology; D006084:Graft Rejection / Q000000981:diagnostic imaging* / Q000209:etiology; D006085:Graft Survival; D006086:Graft vs Host Disease / Q000000981:diagnostic imaging* / Q000209:etiology; D006402:Hematologic Diseases / Q000150:complications* / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors; D014463:Ultrasonography / Q000379:methods*
keywords: color Doppler; gastrointestinal tract; graft-versus-host disease; hematopoietic stem cell transplantation; methylprednisolone; ultrasonography