Department of Ultrasound, Peking University People's Hospital, Beijing, China.
Department of Ultrasound, Peking University People's Hospital, Beijing, China.
Ultrasound Med Biol. 2023 Jun;49(6):1449-1456. doi: 10.1016/j.ultrasmedbio.2023.02.010. Epub 2023 Mar 21.
Hepatic acute graft-versus-host disease (aGVHD) is a serious complication of allogeneic hematopoietic stem cell transplantation (allo-HSCT) and is one of the leading causes of early non-recurrent death. The current diagnosis is based mainly based on clinical diagnosis, and there is a lack of non-invasive quantitative diagnosis methods. We propose a multiparametric ultrasound (MPUS) imaging method and explore its effectiveness in evaluating hepatic aGVHD.
In this study, 48 female Wistar rats were used as receptors and 12 male Fischer 344 rats were used as donors for allo-HSCT to establish aGVHD models. After transplantation, 8 rats were randomly selected for ultrasonic examination weekly, including color Doppler ultrasound, contrast-enhanced ultrasound (CEUS) and shear wave dispersion (SWD) imaging. The values of nine ultrasonic parameters were obtained. Hepatic aGVHD was subsequently diagnosed by histopathological analysis. A classification model for predicting hepatic aGVHD was established using principal component analysis and support vector machines.
According to the pathological results, the transplanted rats were categorized into the hepatic aGVHD and non-GVHD (nGVHD) groups. All parameters obtained by MPUS differed statistically between the two groups. The first three contributing percentages of principal component analysis results were resistivity index, peak intensity and shear wave dispersion slope, respectively. The accuracy of classifying aGVHD and nGVHD using support vector machines reached 100%. The accuracy of the multiparameter classifier was significantly higher than that of the single parameter.
The MPUS imaging method has proven to be useful in detecting hepatic aGVHD.
肝急性移植物抗宿主病（aGVHD）是异基因造血干细胞移植（allo-HSCT）的严重并发症，也是早期非复发性死亡的主要原因之一。目前的诊断主要基于临床诊断，缺乏非侵入性定量诊断方法。我们提出了一种多参数超声（MPUS）成像方法，并探讨其在评估肝 aGVHD 中的有效性。
本研究采用雌性 Wistar 大鼠 48 只作为受体，雄性 Fischer 344 大鼠 12 只作为供体进行 allo-HSCT，建立 aGVHD 模型。移植后每周对 8 只大鼠进行随机超声检查，包括彩色多普勒超声、对比增强超声（CEUS）和剪切波分散（SWD）成像。获得 9 个超声参数值。随后通过组织病理学分析诊断肝 aGVHD。采用主成分分析和支持向量机建立预测肝 aGVHD 的分类模型。
根据病理结果，将移植大鼠分为肝 aGVHD 组和非-GVHD（nGVHD）组。MPUS 获得的所有参数在两组间均有统计学差异。主成分分析结果的前三个贡献率分别为电阻率指数、峰值强度和剪切波分散斜率。支持向量机分类 aGVHD 和 nGVHD 的准确率达到 100%。多参数分类器的准确率明显高于单参数。
MPUS 成像方法在检测肝 aGVHD 方面具有一定的应用价值。
