Institute of Radiology, University Medical Center Regensburg, Regensburg, Germany.
Bone Marrow Transplant. 2011 Jul;46(7):1006-11. doi: 10.1038/bmt.2010.232. Epub 2010 Oct 11.
GVHD is a common complication in patients after allo-SCT. Early detection is important because early therapy may improve the outcome. We evaluated contrast-enhanced ultrasound (CEUS) in patients with GVHD to assess typical imaging features. CEUS was performed in nine patients with histologically proven GVHD. As a control four healthy volunteers and six patients with Crohn's disease (CD) were examined. We employed a high-resolution multi-frequency transducer (6-9 MHz) with contrast harmonic imaging. After the injection of 2.4 mL SonoVue (Bracco, Milan, Italy) intravenously data were acquired and stored digitally. Regions of interest were manually placed over the surrounding mesenteric fat, bowel wall and bowel lumen. Maximum signal increase of each compartment was calculated. Patients with CD and GVHD showed significant contrast uptake in the bowel wall. In contrast to CD patients and healthy volunteers, patients with GVHD showed transmural penetration of microbubbles into the bowel lumen. We assume that the damaged gut mucosal barrier in GVHD enables the microbubbles to penetrate through the bowel wall into the bowel lumen. The penetration of microbubbles into the bowel lumen may serve as a novel diagnostic feature for GVHD if confirmed in controlled clinical trials.
移植物抗宿主病（GVHD）是异基因造血干细胞移植（allo-SCT）后患者的常见并发症。早期发现非常重要，因为早期治疗可能改善预后。我们评估了对比增强超声（CEUS）在 GVHD 患者中的应用，以评估其典型的影像学特征。CEUS 检查了 9 例经组织学证实的 GVHD 患者。作为对照，检查了 4 名健康志愿者和 6 例克罗恩病（CD）患者。我们使用了具有对比谐波成像的高分辨率多频探头（6-9 MHz）。静脉注射 2.4 mL SonoVue（Bracco，米兰，意大利）后，数字化采集和存储数据。手动将感兴趣区域置于周围肠系膜脂肪、肠壁和肠腔上。计算每个部位的最大信号增强。CD 患者和 GVHD 患者的肠壁均显示明显的对比剂摄取。与 CD 患者和健康志愿者不同，GVHD 患者的微泡穿透肠壁进入肠腔。我们假设 GVHD 中受损的肠道黏膜屏障使微泡穿透肠壁进入肠腔。如果在对照临床试验中得到证实，微泡穿透肠腔可能成为 GVHD 的一种新的诊断特征。
