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

  • Magnetic Resonance
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Abstract

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

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Acknowledgments

The scientific guarantor of this publication is Thorsten Derlin. The authors of this manuscript declare relationships with the following companies: none declared. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. Institutional review board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. No study subjects or cohorts have been previously reported. Methodology: retrospective, diagnostic or prognostic study, performed at one institution.

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Authors and Affiliations

  1. Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

    Thorsten Derlin, Azien Laqmani, Simon Veldhoen, Gerhard Adam & Peter Bannas

  2. Department of Nuclear Medicine, Hanover Medical School, Hanover, Germany

    Thorsten Derlin

  3. Department of Diagnostic and Interventional Radiology, University Medical Center Würzburg, Würzburg, Germany

    Simon Veldhoen

  4. Department of Radiology and Nuclear Medicine, Otto-von-Guericke University, Magdeburg, Germany

    Ivayla Apostolova

  5. Department of Stem Cell Transplantation, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

    Francis Ayuk & Nicolaus Kröger

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  1. Thorsten Derlin
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Correspondence to Thorsten Derlin.

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Derlin, T., Laqmani, A., Veldhoen, S. et al. Magnetic resonance enterography for assessment of intestinal graft-versus-host disease after allogeneic stem cell transplantation. Eur Radiol 25, 1229–1237 (2015). https://doi.org/10.1007/s00330-014-3503-4

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  • DOI: https://doi.org/10.1007/s00330-014-3503-4

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