Hepatic veno-occlusive disease after myeloablative treatment and bone marrow transplantation: value of gray-scale and Doppler US in 100 patients
Autor: | Nathalie Lassau, Hartmann O, J L Pico, E Benhamou, Jérome Leclère, J H Bourhis, Anne Auperin, Dominique Valteau-Couanet, Alain Roche, A Ibrahim, Jacques Bosq, T. Girinski |
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Rok vydání: | 1997 |
Předmět: |
Adult
Male medicine.medical_specialty Transplantation Conditioning Hepatic veno-occlusive disease medicine.medical_treatment Hepatic Veno-Occlusive Disease Graft vs Host Disease Hematopoietic stem cell transplantation Sensitivity and Specificity Diagnosis Differential Predictive Value of Tests Hypertension Portal medicine Humans Radiology Nuclear Medicine and imaging Prospective Studies Child Busulfan business.industry Vascular disease Liver Diseases Hematopoietic Stem Cell Transplantation Ultrasonography Doppler Total body irradiation Prognosis medicine.disease Surgery Transplantation medicine.anatomical_structure Female Bone marrow Radiology Complication business Immunosuppressive Agents Whole-Body Irradiation medicine.drug |
Zdroj: | Radiology. 204:545-552 |
ISSN: | 1527-1315 0033-8419 |
Popis: | To determine the value of gray-scale ultrasonography (US) and Doppler US in the prediction, diagnosis, and prognostic assessment of hepatic veno-occlusive disease (HVOD).One hundred patients (median age, 22 years; range, 18 months to 59 years) receiving total body irradiation or busulfan therapy as intensive treatment before hematopoietic stem cell transplantation were studied prospectively. Each patient underwent gray-scale and Doppler US examination before transplantation and weekly thereafter while hospitalized (about four examinations per patient). Seven gray-scale morphologic criteria and seven Doppler criteria were studied, yielding three individual scores: gray-scale score, Doppler score, and total score.Twenty-five patients developed HVOD; nine of these patients died. Positive predictive values of the 14 criteria were 31%-95%, and negative predictive values were 85%-96%. The three scores correlated with the clinical diagnosis of HVOD. Depending on the cutoff value, the positive predictive value of the total score was 44%-89% and the negative predictive value was 91%-98%. The gray-scale and Doppler criteria differed significantly between patients with HVOD and those with graft-versus-host disease of the liver (P = 10(-4)).Even if there is overlap in findings between patients with and those without HVOD, gray-scale and Doppler US are valid for positive and differential diagnosis and have predictive and prognostic relevance. |
Databáze: | OpenAIRE |
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