Graft-versus-host disease other imaging findings

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Graft-versus-host disease

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Shyam Patel [2]

Overview

Plain films, CT scans, and MRI scans have been studied in the past for GvHD diagnosis. However, current data does not support their use for GvHD diagnosis. These imaging modalities may be helpful in ambiguous cases or if there is concern about other ongoing disease processes, like infections.

Other Imaging Findings

Imaging modalities have been used to diagnose GvHD, as certain radiographic features can suggest for or against a diagnosis of GvHD. However, radiographic findings are non-specific, as these can be found in various other diseases.

  • Abdominal plain films (abdominal X-rays) were used in the 1980s in an attempt to diagnose GvHD. It was noted in 1988 that 95% of patients had separation of bowel loops on abdominal X-ray, suggesting wall thickening, air fluid levels, or dilatation of the small bowel.[1]
  • CT scans has been used to diagnose GvHD: radiographic features include bowel wall thickening and mucosal enhancement. Acute GvHD tends to present radiographically with moderate bowel wall thickening.[1] However, these radiographic features are also common to Clostridium difficile colitis.[1] C. difficile or CMV colitis tends to present with severe bowel wall thickening.
  • MRI can be used though this test is highly expensive and cost-ineffective relative to the diagnostic yield. MRI of the abdomen would should bowel wall thickening and mucosal enhancement with gadolinium.[1]

References

  1. 1.0 1.1 1.2 1.3 Malard F, Mohty M (2014). "New insight for the diagnosis of gastrointestinal acute graft-versus-host disease". Mediators Inflamm. 2014: 701013. doi:10.1155/2014/701013. PMC 3964897. PMID 24733964.

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