Diagnosing acute intestinal graft-versus-host disease by a non-invasive method: transabdominal ultrasonography and colour doppler imaging

Abdominal ultrasound examination showed a thickened bowel wall in the jejunal and ileal region and free abdominal fluid; colour doppler imaging of the arterial blood flow in the superior mesenteric artery showed increased perfusion (figure). Even though endoscopy remains the gold standard for diagno...

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Bibliographic Details
Published in:The Lancet (British edition) 2021-09, Vol.398 (10306), p.1170-1170
Main Authors: Spadea, Manuela, Saglio, Francesco, Pessolano, Rosanna, Opramolla, Anna, Calvo, Pier Luigi, Fagioli, Franca
Format: Article
Language:English
Subjects:
Abdomen
Abdomen - diagnostic imaging
Adrenoleukodystrophy - therapy
Beclomethasone - therapeutic use
Blood flow
Child
Color
Computed tomography
Doppler effect
Endoscopy
Glucocorticoids - therapeutic use
Graft versus host disease
Graft vs Host Disease - diagnostic imaging
Graft vs Host Disease - drug therapy
Graft-versus-host reaction
Humans
Intestinal Diseases - diagnostic imaging
Intestinal Diseases - drug therapy
Intestine
Intravenous administration
Magnetic resonance
Male
Medical diagnosis
Medical imaging
Nitriles - therapeutic use
Patients
Perfusion
Positron emission
Pyrazoles - therapeutic use
Pyrimidines - therapeutic use
Stem Cell Transplantation - methods
Tomography
Ultrasonic imaging
Ultrasonography - methods
Ultrasonography, Doppler, Color
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Summary:Abdominal ultrasound examination showed a thickened bowel wall in the jejunal and ileal region and free abdominal fluid; colour doppler imaging of the arterial blood flow in the superior mesenteric artery showed increased perfusion (figure). Even though endoscopy remains the gold standard for diagnosing GVHD, it is associated with the risk of major life-threatening complications when undertaken in such clinically vulnerable patients. [...]alternative radiological investigations—including a CT scan with intravenous and oral contrast, magnetic resonance enterography, PET-CT, and both standard and contrast-enhanced ultrasonography—need to be considered for diagnosing and assessing GVHD. Notably, standard and contrast-enhanced ultrasonography combined with colour-coded and power doppler—as shown in this case—are valuable, time-saving, non-invasive and non-ionising, readily repeatable, and well tolerated investigations for the diagnosis, assessment, and follow-up of patients with intestinal GVHD (video).
ISSN:0140-6736
1474-547X
DOI:10.1016/S0140-6736(21)01918-8