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01.08.2014 | Gastrointestinal

Assessment of acute intestinal graft versus host disease by abdominal magnetic resonance imaging at 3 Tesla

verfasst von: Johannes Budjan, Henrik J. Michaely, Ulrike Attenberger, Stefan Haneder, Daniela Heidenreich, Sebastian Kreil, Florian Nolte, Wolf-Karsten Hofmann, Stefan O. Schoenberg, Stefan A. Klein

Erschienen in: European Radiology | Ausgabe 8/2014

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Abstract

Objectives

After allogeneic stem cell transplantation (SCT), a reliable diagnosis of acute graft versus host disease (aGvHD) is essential for an early and successful treatment. It is the aim of this analysis to assess intestinal aGvHD by magnetic resonance imaging (MRI).

Methods

Prior to allogeneic SCT, 64 consecutive patients underwent abdominal MRI examination on a 3 T MR system, including axial and coronal T2w sequences and a three-dimensional dynamic T1w, contrast enhanced sequence. After SCT, 20 patients with suspected aGvHD received a second MRI as well as an endoscopic examination.

Results

Nine patients suffered from histologically proven intestinal aGvHD. In eleven patients intestinal aGvHD was excluded. In all aGvHD patients typical MRI findings with long-segment bowel wall thickening - always involving the terminal ileum - with profound submucosal oedema, were detected. The bowel wall was significantly thickened in patients with intestinal aGvHD. Bowel contrast enhancement spared the submucosa while demonstrating strong mucosal hyperemia.

Conclusions

In intestinal aGvHD, a characteristic MR-appearance can be detected. This MRI pattern might facilitate an early and non-invasive diagnosis of intestinal aGvHD. MRI might thus be used as a sensitive tool to rule out or support the clinical diagnosis of aGvHD.

Key Points

• Acute intestinal graft versus host disease (aGvHD) can be assessed by MRI.

• The aGvHD of the bowel demonstrates a characteristic MR imaging pattern.

• Bowel wall shows extensive long-segment wall thickening with profound submucosal oedema.

• Terminal ileum seems invariably affected; other bowel segments show variable involvement.

• Colonoscopy in suspected aGvHD should include inspection of terminal ileum.

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Titel: Assessment of acute intestinal graft versus host disease by abdominal magnetic resonance imaging at 3 Tesla
verfasst von: Johannes Budjan
Henrik J. Michaely
Ulrike Attenberger
Stefan Haneder
Daniela Heidenreich
Sebastian Kreil
Florian Nolte
Wolf-Karsten Hofmann
Stefan O. Schoenberg
Stefan A. Klein
Publikationsdatum: 01.08.2014
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 8/2014
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-014-3224-8

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Assessment of acute intestinal graft versus host disease by abdominal magnetic resonance imaging at 3 Tesla