Intestinal disease in acquired immunodeficiency: Evaluation by CT

Friedrich D Knollmann, Th Grünewald, A. Adler, J. Mäurer, R. E. Hintze, H. D. Pohle, R. Felix

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4 Scopus citations

Abstract

Intestinal symptoms affect most AIDS patients at some point in their disease. The purpose of this study was to evaluate the use of CT in this setting. A total of 339 abdominal CT exams were reviewed for signs of intestinal disease. Abdominal CT scans of 45 patients with intestinal symptoms were compared with colonoscopy and histologic data. The CT results were correlated with CD4+ T-lymphocyte counts and patient survival. More than 14 % of all abdominal CT exams displayed signs of enteric disease. Of the 45 patients studied with both CT and colonoscopy, 35 (78 %) had signs of intestinal disease by CT. Of these 35 patients, colonoscopic signs of an intestinal lesion were found in 29 and histologic proof of disease was established in 30 cases. Colonoscopy and histology detected 8 lesions missed by CT. There were 14 cases of unspecific colitis, 15 cases of cytoinegalovirus (CMV) colitis, and 4 cases of enteric tuberculosis as per biopsy. Five patients presented with Kaposi's sarcoma and 1 with a non-Hodgkin's lymphoma. Neither colonoscopic nor CT signs of intestinal disease did reliably distinguish between histologic subgroups. Specifically, CMV colitis could not be distinguished from unspecific colitis. CD4+ T-lymphocyte counts for histologic subgroups were not significantly different, either. No colonoscopic or histologic feature predicted survival, whereas low CD4 counts and ascites on CT indicated a poor prognosis. Whereas CT detects signs of intestinal disease in most AIDS patients, these signs remain largely unspecific. Colonoscopy and biopsies provide no consistently valid standard with which to compare CT because of controversial sensitivity and specificity of these methods. The CT technique detects small bowel as well as extraintestinal disease. Therefore, CT is an important diagnostic modality in abdominal disease of immunocompromised patients.

Original languageEnglish (US)
Pages (from-to)1419-1429
Number of pages11
JournalEuropean Radiology
Volume7
Issue number9
StatePublished - 1997
Externally publishedYes

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Keywords

  • AIDS
  • Bowel disease
  • Colitis
  • CT
  • Cytomegalovirus
  • Human immunodeficiency virus

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Knollmann, F. D., Grünewald, T., Adler, A., Mäurer, J., Hintze, R. E., Pohle, H. D., & Felix, R. (1997). Intestinal disease in acquired immunodeficiency: Evaluation by CT. European Radiology, 7(9), 1419-1429.