Diagnosis of Graft-Versus-Host Disease after Bone Marrow Transplantation by in vivo Proton MR Spectroscopy of the Liver： Correlation with Pathologic Results

Purpose： To know the differences of the proton MR spectroscopic features of the liver between th patients with graft-versus-host disease (GVHD) and without GVHD (non-GVHD) after to marrow transplantation (BMT), and to evaluate the possibility to discriminate GVHD fro non-GVHD by analysis of the in vivo proton MR spectra. Method： We evaluated the in vivo proton MR spectra from the livers of 37 patients wh underwent BMT. Our series included 14 cases with GVHD and 23 without GVHD in the liver. Nineteen men and 18 women were included in our series. All cases of GVHD and 2 o non-GVHD were confirmed by liver biopsy and remaining of non-GVHD by evaluation clinical follow up. Proton MR spectroscopy (1H-MRS) was performed at 1.5T GE Sign Horizon (GE Medical System, Milwaukee, USA) system using localized proton STEAM sequence and body coil in all cases with subjects were located in supine position. N respiratory interruption was required during the spectroscopic signal acquisition. Paramete using in MRS were： TR = over 3000ms, TE = 30ms, number of scans = 128, voxel size = ($2{\times}2{\times}2$)$cm^3$, and one NEX. We evaluated the spectra with an attention to the differences o patterns of the peaks between GVHD and non-GVHD groups. The ratio of peak area of peaks at 1.6-4.1ppm to lipid (0.9-1.6ppm) [P(1.6-4.1ppm)/P(0.9-1.6ppm)] was calculated in GVHD and non-GVHD group, and compared the results between these groups. We als evaluated the sensitivity and specificity for discriminating GVHD from non-GVHD by anal of 1H-MRS.