Donnelly L F, Morris C L
Department of Radiology, Children's Hospital Medical Center, Cincinnati, OH 45229, USA.
Radiology. 1996 Apr;199(1):265-8. doi: 10.1148/radiology.199.1.8633157.
To review the computed tomographic (CT) appearance of acute gastrointestinal graft-versus-host disease (GVHD) in children.
Sixteen abdominal CT scans obtained in 12 children with acute gastrointestinal GVHD who underwent allogeneic bone marrow transplantation (BMT) were compared with 16 CT scans obtained in autologous bone marrow recipients not at risk for GVHD (control group). Autopsy findings in six patients with GVHD were compared with CT findings.
All CT scans in patients with GVHD showed an abnormally enhanced, thin mucosal layer of bowel wall involving fluid-filled, dilated, poorly opacified bowel loops from the duodenum to the rectum. This corresponded histologically to mucosal destruction and replacement by a thin layer of highly vascular granulation tissue. Bowel wall thickening was often absent. Infiltration of mesenteric fat was seen in 91% of patients The control group showed no similar abnormalities.
Acute gastrointestinal GVHD characteristically appears on CT scans as multiple, diffuse, fluid-filled bowel loops with a thin, enhancing layer of bowel wall mucosa. Bowel wall thickening often is absent.
回顾儿童急性胃肠道移植物抗宿主病（GVHD）的计算机断层扫描（CT）表现。
将12例接受异基因骨髓移植（BMT）的急性胃肠道GVHD患儿的16份腹部CT扫描结果，与16份自体骨髓移植受者（无GVHD风险，作为对照组）的CT扫描结果进行比较。将6例GVHD患者的尸检结果与CT表现进行比较。
GVHD患者的所有CT扫描均显示肠壁黏膜层异常强化且变薄，累及从十二指肠到直肠的充满液体、扩张且造影不佳的肠袢。这在组织学上对应于黏膜破坏并被一层薄的高血管化肉芽组织替代。肠壁增厚通常不明显。91%的患者可见肠系膜脂肪浸润。对照组未显示类似异常。
急性胃肠道GVHD在CT扫描上的特征表现为多个弥漫性充满液体的肠袢，伴有肠壁黏膜层薄而强化。肠壁增厚通常不明显。
