Division of Laboratory and Transfusion Medicine, Hokkaido University Hospital, Sapporo, Japan; Diagnostic Center for Sonography, Hokkaido University Hospital, Sapporo, Japan.
Department of Hematology, Hokkaido University Hospital, Sapporo, Japan.
Biol Blood Marrow Transplant. 2018 Sep;24(9):1896-1900. doi: 10.1016/j.bbmt.2018.05.025. Epub 2018 May 24.
Sinusoidal obstruction syndrome (SOS)/hepatic veno-occlusive disease (VOD) is a well-documented complication after hematopoietic stem cell transplantation (HSCT). Transabdominal ultrasonography (US) enables the visualization of blood flow abnormalities and is therefore useful for the diagnosis of SOS/VOD. We herein prospectively evaluated accuracy of a novel US diagnostic scoring system of SOS/VOD based on US findings. We carried out US in 106 patients on day 14 and when SOS/VOD was suspected after allogeneic HSCT. Among 106 patients, 10 patients (9.4%) were diagnosed as SOS/VOD by Baltimore or Seattle criteria. According to univariate analysis of 17 US findings (US-17 screening), we established a novel scoring system (HokUS-10) consisting of 10 parameters, such as gallbladder wall thickening, ascites, and blood flow signal in the paraumbilical vein. The sensitivity and specificity were 100% and 95.8%, respectively. Diagnostic performance of the HokUS-10 was significantly better than US-17 screening. In 4 of 10 patients US detection of SOS/VOD preceded to clinical diagnosis. The HokUS-10 scoring system is useful in the diagnosis of SOS/VOD; however, our results should be validated in other cohorts.
窦状隙阻塞综合征（SOS）/肝静脉阻塞性疾病（VOD）是造血干细胞移植（HSCT）后一种有充分记录的并发症。经腹部超声（US）可使血流异常可视化，因此有助于 SOS/VOD 的诊断。我们在此前瞻性地评估了一种基于 US 发现的 SOS/VOD 新型 US 诊断评分系统的准确性。我们在异基因 HSCT 后第 14 天对 106 例患者进行了 US 检查，并在怀疑 SOS/VOD 时进行了检查。在 106 例患者中，根据巴尔的摩或西雅图标准，有 10 例（9.4%）被诊断为 SOS/VOD。根据 17 项 US 发现的单因素分析（US-17 筛选），我们建立了一种新型评分系统（HokUS-10），由 10 个参数组成，如胆囊壁增厚、腹水和脐旁静脉的血流信号。其灵敏度和特异性分别为 100%和 95.8%。HokUS-10 的诊断性能明显优于 US-17 筛选。在 10 例患者中，有 4 例患者的 SOS/VOD 通过 US 检测早于临床诊断。HokUS-10 评分系统对 SOS/VOD 的诊断有用；然而，我们的结果需要在其他队列中验证。
