CT鉴别诊断造血干细胞移植后胃肠道移植物抗宿主病与机会性感染性肠炎

CT for differential diagnosis of gastrointestinal graft versus host disease and opportunistic infectious enteritis after hematopoietic stem cell transplantation

目的观察CT鉴别诊断造血干细胞移植(HSCT)后胃肠道移植物抗宿主病(GI-GVHD)与机会性感染性肠炎的价值。方法回顾性分析59例HSCT后出现胃肠道症状且经内窥镜下组织活检病理确诊GI-GVHD(GI-GVHD组,n=31)或机会性感染性肠炎(机会性感染性肠炎组,n=28)患者,观察其CT表现差异。结果GI-GVHD组CT显示肠壁增厚、肠壁强化、肠管积气及肠外CT表现肠周淋巴结增生、胆囊炎、膀胱炎或膀胱出血率均高于机会性感染性肠炎组(P均<0.05),而CT显示多灶性肠壁炎症及肠系膜水肿率组间差异均无统计学意义(P均>0.05)。结论CT有助于鉴别诊断HSCT后GI-GVHD与机会性感染性肠炎。

Objective To explore the value of CT for differential diagnosis of gastrointestinal graft versus host disease(GI-GVHD)and opportunistic infectious enteritis after hematopoietic stem cell transplantation(HSCT).Methods Fifty-nine patients with gastrointestinal symptoms after HSCT and pathologically confirmed GI-GVHD(GI-GVHD group,n=31)or opportunistic infectious enteritis(opportunistic infectious enteritis group,n=28)through endoscopic tissue biopsy were retrospectively observed,and the CT manifestations were comparatively analyzed.Results The incidence of intestinal wall thickening,intestinal wall enhancement,intestinal pneumatosis of intestinal CT manifestations and periintestinal lymph node hyperplasia,cholecystitis,cystitis or bladder hemorrhage in GI-GVHD group were all higher than those in opportunistic infectious enteritis group(all P<0.05),while there was no significant difference of the incidence of multifocal intestinal wall inflammation nor mesenteric edema between groups(both P>0.05).Conclusion CT was helpful for differential diagnosis of GI-GVHD and opportunistic infective enteritis after HSCT.