Digestive Disease Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 10 Center Dr., Room 5-2740, Bethesda, MD, 20892, USA.
Miami Cardiac and Vascular Institute, 8900 N. Kendal Drive, Miami, FL, 33176, USA.
Dig Dis Sci. 2022 May;67(5):1831-1842. doi: 10.1007/s10620-021-06978-4. Epub 2021 May 1.
Chronic granulomatous disease (CGD) is a rare primary immunodeficiency which can lead to gastrointestinal (GI) complications including inflammatory bowel disease. Radiographic findings in this cohort have not been well described.
To describe the frequency and spectrum of gastrointestinal abnormalities seen on computed tomography (CT) in patients with CGD and determine whether radiography was predictive of endoscopic or histopathologic inflammatory findings.
A retrospective review was conducted on 141 consecutive CGD patients seen at the National Institutes of Health between 1988 and 2011. All corresponding CTs were reviewed for gastrointestinal abnormalities including wall thickening. Endoscopic and histopathologic findings were reviewed in subjects with documented endoscopy within 30 days of an imaging study. Findings were compared between patients with and without wall thickening on CT to determine whether bowel wall thickening was predictive of endoscopic or histologic inflammatory findings.
Two hundred and ninety-two CTs were reviewed. GI wall thickening was present on CT in 61% of patients (n = 86). Among a subgroup of 20 patients who underwent endoscopy at the time of their imaging, there was a statistically significant correlation between radiographic gastrointestinal wall thickening and endoscopic inflammation in the same intestinal segment (p = 0.035). Additionally, there was a significant correlation between radiographic gastrointestinal wall thickening and inflammatory features on histopathology (p = 0.02).
GI abnormalities are commonly observed on CT in CGD patients. Bowel wall thickening correlates with endoscopic and histopathologic evidence of inflammation. These findings may be used to better facilitate directed endoscopic assessment and histopathologic sampling in patients with CGD.
慢性肉芽肿病（CGD）是一种罕见的原发性免疫缺陷病，可导致胃肠道（GI）并发症，包括炎症性肠病。该队列的放射学表现尚未得到很好的描述。
描述 CGD 患者 CT 上胃肠道异常的频率和范围，并确定放射摄影是否可预测内镜或组织病理学炎症发现。
对 1988 年至 2011 年期间在国立卫生研究院就诊的 141 例连续 CGD 患者进行回顾性研究。对所有相应的 CT 进行胃肠道异常（包括壁增厚）的回顾。对有记录的影像学研究后 30 天内进行内镜检查的患者，对内镜和组织病理学发现进行回顾。比较 CT 上有和无肠壁增厚的患者之间的发现，以确定肠壁增厚是否可预测内镜或组织学炎症发现。
共回顾了 292 次 CT。61%的患者（n=86）的 CT 显示存在 GI 壁增厚。在同时进行影像学和内镜检查的 20 例患者亚组中，同一肠段的放射学胃肠道壁增厚与内镜炎症之间存在统计学显著相关性（p=0.035）。此外，放射学胃肠道壁增厚与组织病理学上的炎症特征之间存在显著相关性（p=0.02）。
CGD 患者的 CT 上常可见胃肠道异常。肠壁增厚与内镜和组织病理学炎症证据相关。这些发现可用于更好地促进 CGD 患者的定向内镜评估和组织病理学采样。
