Acute graft-versus-host disease in children: abdominal CT findings.
OBJECTIVE
To review the computed tomographic (CT) appearance of acute gastrointestinal graft-versus-host disease (GVHD) in children.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Donnelly
L F
LF
Department of Radiology, Children's Hospital Medical Center, Cincinnati, OH 45229, USA.
Morris
C L
CL
D000208:Acute Disease; D016026:Bone Marrow Transplantation / Q000009:adverse effects; D016022:Case-Control Studies; D002648:Child; D005260:Female; D005767:Gastrointestinal Diseases / Q000000981:diagnostic imaging* / Q000209:etiology / Q000473:pathology; D006086:Graft vs Host Disease / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D007413:Intestinal Mucosa / Q000000981:diagnostic imaging / Q000473:pathology; D007422:Intestines / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed