Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China.
Department of pathology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China.
Biomed Res Int. 2020 Jun 22;2020:2978410. doi: 10.1155/2020/2978410. eCollection 2020.
To improve the identification and computed tomography (CT) diagnostic accuracy of chronic active Epstein-Barr virus (EBV)-associated enteritis (CAEAE) by evaluating its CT findings and clinical manifestation.
The data of three patients with pathologically and clinically confirmed CAEAE who underwent CT enterography (CTE) were retrospectively reviewed from January 2018 to October 2019. The following data were evaluated: imaging characteristics (length of involvement, pattern of mural thickening, pattern of attenuation, perienteric abnormalities), clinical symptoms, endoscopic records, laboratory examinations, and pathologic findings.
Based on CT findings, two patients demonstrated segmental bowel wall thickening (involvement length >6 cm), asymmetric thickening, layered attenuation, fat stranding, and adenopathy, whereas the remaining one had no positive finding. The endoscopic results of all patients showed numerous irregular ulcers in the colon, and one patient had a focal esophageal ulcer. The major clinical symptoms were abdominal pain ( = 3), retrosternal pain ( = 1), fever ( = 3), diarrhea ( = 2), hematochezia ( = 1), and adenopathy ( = 3). The main laboratory examination indicators were increased serum EBV DNA load ( = 1) and increased inflammatory markers ( = 3). With regard to the main pathologic findings, all patients showed positive EBV-encoded RNA (EBER) situ hybridization in the colonic biopsy specimen, with one patient being positive in the esophagus.
CAEAE is rare and is usually misdiagnosed as inflammatory bowel disease (IBD). The imaging features of CAEAE overlap with those of Crohn's disease and ulcerative colitis. The presence of segmental and asymmetric bowel wall thickening, layered attenuation, and fat stranding in the CTE image may be helpful in differentiating CAEAE from IBD.
通过评估慢性活动性 EBV 相关肠炎（CAEAE）的 CT 表现和临床表现，提高其识别和 CT 诊断准确性。
回顾性分析 2018 年 1 月至 2019 年 10 月期间经病理和临床证实的 3 例 CAEAE 患者的 CT 肠造影（CTE）数据。评估以下数据：影像学特征（受累长度、肠壁增厚模式、衰减模式、肠周异常）、临床症状、内镜记录、实验室检查和病理结果。
根据 CT 结果，2 例患者表现为节段性肠壁增厚（受累长度>6cm）、不对称性增厚、分层衰减、脂肪条纹和淋巴结肿大，而另 1 例患者无阳性发现。所有患者的内镜结果均显示结肠有多个不规则溃疡，1 例患者有食管局灶性溃疡。主要临床症状为腹痛（=3）、胸骨后疼痛（=1）、发热（=3）、腹泻（=2）、血便（=1）和淋巴结肿大（=3）。主要实验室检查指标为血清 EBV DNA 载量增加（=1）和炎症标志物增加（=3）。在主要病理发现方面，所有患者的结肠活检标本均显示 EBV 编码 RNA（EBER）原位杂交阳性，1 例患者的食管阳性。
CAEAE 较为罕见，常被误诊为炎症性肠病（IBD）。CAEAE 的影像学特征与克罗恩病和溃疡性结肠炎重叠。CTE 图像中存在节段性和不对称性肠壁增厚、分层衰减和脂肪条纹可能有助于将 CAEAE 与 IBD 区分开来。
