造血干细胞移植后急性移植物抗宿主病的CT表现及文献复习

CT Features of Acute Graft-versus-host Disease After Allogenic Hemopoietic Stem Cell Transplantation(Allo-HSCT) and Literature Review

目的阐述血液病患者造血干细胞移植(HSCT)治疗后并发急性移植物抗宿主病(aGVHD)的CT表现,探讨其在aGVHD诊断中的临床意义。方法对8例HSCT患者进行胸部HRCT扫描及腹部动态增强CT扫描,分析aGVHD患者(8例)双肺、肝脏、胆囊、胰腺、脾脏及肠道CT图像改变特征。结果 aGVHD患者中CT异常征象包括:双肺斑片状磨玻璃影、胆囊壁增厚、脾脏体积增大及肠壁增厚、肠粘膜明显强化等一系列改变。结论 HSCT治疗后并发aGVHD患者的CT改变虽无明显特异性,但影像学检查对于造血干细胞移植后不同并发症之间的鉴别诊断和活检定位提供较为可靠的影像学依据。

Objective To elaborate the CT features of acute graft-versus-host disease in adults who receive allogenic hemopoietic stem cell transplantation （Allo-HSCT） and inves- tigate the efficacy of CT ill tile dia^losis of aGVHD, methods Patients （n=10） with a history of allogeneic bone marrow transplantation and pathologically or clinical confirmed acute gastrointestinal graft-versus-host disease underwent abdominal contrast-enhanced 01=6） CT and chest HRCT （n=3） and urinary contrast-enhanced （n=l） CT. CT scans were retrospectively evaluated for chest and abdominal CT abnormalities in pulmonary, liver, gallbladder, pancreatins, spleen, ureter, bladder and gastrointestinal tract. Results CT fea- tnres in aGVHD patients included a bilateral ~round-glass Pattern in pulmonary, gallbladder wall thickening, splenomegaly, intestinal wall thickening, stranding of the mesenteric fat, nmeosal enhancement, and ureter wall thickening. Conclusion Though imaging features seen on CT scan in patients with aGVHD after allo-HSCT is not specific, CT scan examina- tion can provide reliable evidences for differential diaznosis of various complications and biopsy location alter allo-HSCT