Authors:
H. Brodoefel1, M. Vogel2, W. Bethge2, C. Faul2, M. Wehrmann2, C. Claussen2, M. S. Horger2; 1Boston, MA/US, 2Tuebingen/DE
DOI:
10.1594/ecr2008/C-487
Results
Frequent intestinal abnormalities included wall thickening, abnormal enhancement, and excessive fluid-filling (94%, 89%, 94%; Table 1). Bile tract abnormality proved the commonest extra-intestinal finding (74%; Table 2).
Both, measurements or frequencies of intestinal or extraintestinal abdominal CT findings were not significantly different between subgroups of early or late-onset acute GvHD (Table 1 and 2).
Among intestinal CT findings, wall thickness and mucosal attenuation in unenhanced scans were significantly related to gut (P=0.012; 0.0001), overall clinical (P=0.044; 0.009) and pathological grading (P=0.018; 0.012). In addition, the total number of abnormal bowel segments and the presence of small bowel dilatation were correlated to gut (P=0.019; 0.009) and clinical grading (P=0.28; 0.035). Among extraintestinal CT signs, ascites was proved to be significantly associated with gut (P=0.011) or clinical score (P=0.043); the comb and misty mesentery sign were linked to the gut grading only (P=0.007; 0.017).
A comprehensive CT score which integrates 12 CT pathologies was found to significantly correlate with gut, overall clinical and pathology grading (Table 3; Figure 1; P=0.0007; 0.003; 0.009; r=0.61; 0.58; 0.47). The same was true for a more practicable CT grading considering 6 individually significant predictor variables only (Table 3; Figure 1; P=0.004; 0.014; 0.029; r=0.54; 0.49; 0.47).
Imaging examples are provided in Figure 2 and 3.