Chae Eun Young, Lee Seung Soo, Chung Jun-Won, Kim Hyun Jin, Park Seong Ho, Kim Ah Young, Ha Hyun Kwon
Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
J Comput Assist Tomogr. 2010 Nov-Dec;34(6):892-8. doi: 10.1097/RCT.0b013e3181ecc471.
To describe the clinical and radiologic features of cytomegalovirus (CMV) enterocolitis in apparently immunocompetent hosts.
Our institutional review board approved this retrospective study, and informed consent was waived. Twelve apparently immunocompetent patients (7 women and 5 men; mean age, 58 years) with pathologically proven CMV enterocolitis were included. Computed tomographic (CT) scans were retrospectively reviewed to determine the extent and the location of mural thickening, maximal mural thickness, enhancement pattern, that is, single-halo, double-halo, and homogeneous patterns, and ascites.
Eight patients had comorbidities potentially affecting the host immune status, whereas 4 patients were apparently healthy before presentation. On CT, all patients showed mural thickening (range, 4-11 mm) involving the colon (n = 8), the small bowel (n = 1), or both (n = 3). Segmental involvement was most common (n = 9 for colon and n = 2 for small bowel), whereas focal involvement of the rectum (n = 1) and diffuse involvement of the entire ileum (n = 1) or the entire small bowel and colon (n = 1) were also noted. Colonic lesions showed variable enhancement patterns, including the single-halo (n = 6), homogeneous (n = 3), and double-halo patterns (n = 2), whereas all small-bowel lesions in 4 patients exhibited a single-ring pattern. Ascites was present in 7 patients. Complications requiring surgery occurred in 3 patients and included refractory bleeding (n = 2) and bowel perforation (n = 1).
Cytomegalovirus enterocolitis in immunocompetent hosts typically develops in elderly subjects with comorbidities, although it may also affect relatively young and healthy subjects. On CT, it is characterized by mild mural thickening of the small bowel and the colon and frequently shows segmental involvement and a single-halo enhancement pattern.
描述在表面免疫功能正常宿主中巨细胞病毒（CMV）小肠结肠炎的临床和放射学特征。
我们机构的审查委员会批准了这项回顾性研究，并免除了知情同意。纳入了12例经病理证实为CMV小肠结肠炎的表面免疫功能正常的患者（7名女性和5名男性；平均年龄58岁）。对计算机断层扫描（CT）图像进行回顾性分析，以确定肠壁增厚的范围和位置、最大肠壁厚度、强化方式，即单晕、双晕和均匀强化方式，以及腹水情况。
8例患者有潜在影响宿主免疫状态的合并症，而4例患者在发病前表面健康。CT检查显示，所有患者均有肠壁增厚（范围4 - 11毫米），累及结肠（8例）、小肠（1例）或两者（3例）。节段性受累最为常见（结肠9例，小肠2例），同时也注意到直肠的局灶性受累（1例）以及整个回肠（1例）或整个小肠和结肠（1例）的弥漫性受累。结肠病变表现出多种强化方式，包括单晕（6例）、均匀强化（3例）和双晕强化（2例），而4例患者的所有小肠病变均表现为单环强化方式。7例患者存在腹水。3例患者发生了需要手术的并发症，包括难治性出血（2例）和肠穿孔（1例）。
免疫功能正常宿主中的巨细胞病毒小肠结肠炎通常发生在有合并症的老年人中，尽管它也可能影响相对年轻和健康的个体。在CT上，其特征为小肠和结肠的轻度肠壁增厚，常表现为节段性受累和单晕强化方式。
