嗜酸性胃肠炎的CT表现及临床特征分析

目的探讨嗜酸性粒细胞胃肠炎(EG)的CT表现及临床特征。方法回顾性分析经临床证实的15例EG住院患者的CT表现及临床资料。15例患者中,经胃镜及肠镜活检确诊EG者11例,余4例由外周血嗜酸性粒细胞升高且经激素治疗症状消失而确诊。所有患者均行CT平扫,其中9例行CT平扫同时增强扫描。结果 15例EG临床主要表现为腹痛、腹胀,5例伴呕吐,4例伴腹泻,2例伴发热。15例中CT有胃肠道异常表现者12例,病变累及食管4例,胃4例,十二指肠3例,空肠或回肠3例,结肠3例。CT主要表现为食管及胃肠道广泛水肿增厚,可呈分层状,黏膜增粗,此外肠系膜渗出3例,少量至中等量腹腔积液6例。15例中外周血嗜酸性粒细胞计数升高13例。所有患者对激素治疗敏感。结论嗜酸性粒细胞胃肠炎临床表现无特异性,其CT表现有一定特征,结合外周血嗜酸性粒细胞增高,可提示诊断。

Clinical and CT features of eosinophilic gastroenteritis

Objective To evaluate the clinical and CT features of eosinophilic gastroenteritis (EG). Methods Theclinical records,noncontrast (15) and contrast-enhanced (9) CT of 15 in-patients with EG confirmed by endoscopic biopsy (11) or peripheral blood eosinophilia and response to hormone therapy (4)were retrospectively analyzed. Results The clinical presentation was abdominal pain and distention (15), vomiting (5), diarrhea (4), and fever (2). CT abnormalities were demonstrated in the esophagus (4), stomach (4), duodenum (3), jejunum or ileum (3), and colon (3). The dominant CT feature was diffuse esophageal and gastrointestinal mural edema and thickening with halo sign or thickened mucosal fold. Mesenteric exudation (3) and small to medium amount of ascites (5) were also found. Peripheral blood eosinophilia was detected in 13/15 patients with response to hormone therapy. Conclusion Although the clinical manifestation is nonspecific , the CT appearance combined with peripheral blood eosinophilia can suggest the diagnosis of EG.