摘要
目的探讨肝移植术后侵袭性肺曲菌病(invasive pulmonary aspergillosis,IPA)的CT及临床表现。方法回顾性分析自2007年1月～2011年1月25例确诊为IPA的肝移植患者胸部CT及临床表现。结果 21例(84.00%)IPA表现为肿块样实变,增强后无明显强化;在肿块样实变的病例中合并其他类型病灶,其中空洞18例,晕轮征14例,空气半月征8例。4例(16.00%)表现为斑片、大片实变影,无肿块样实变及空洞。25例(100%)IPA患者肺内病灶为多发。经抗真菌治疗后,18例较前好转,4例未见明显变化,3例较前进展。因侵袭性肺曲菌病死亡3例。IPA平均发生时间为肝移植术后31 d。最常见的临床表现为发热(19/25)。25例在诊断为IPA时均无低白细胞血症。结论肝移植术后肺内出现肿块样实变合并空洞、空气半月征及晕轮征等多种形态病灶高度提示IPA。
Objective To determine the CT and clinical features of invasive pulmonary aspergillosis （IPA） after liver transplantation. Methods Clinical records and CT scans of 25 patients with confirmed IPA after liver transplantation were retrospectively evaluated by 2 radiologists. Results The average onset of IPA was 31 days after liver transplantation. The most common symptom at diagnosis was fever （n=19）. None of the 25 patients had leukopenia at the time of diagnosis. All patients had multiple lung lesions. The most frequent CT finding was mass-like consolidation without contrast enhancement （21 patients, 84%） intermixed with cavities （18）, halo sign （14）, and air crescent sign （8）. Patchy consolidation was found in 4 patients （16%） without mass-like consohdation and cavities. After treatment, CT showed improvement in 18 patients, was unchanged in 4 patients, and showed disease progression in 3 patients. There were 3 aspergillosis-associated deaths during the follow-up period. Conclusion Mass-like consolidation intermixed with cavities, air crescent sign and halo sign is the characteristic CT feature of IPA after liver transplantation.
出处
《影像诊断与介入放射学》
2012年第1期21-24,共4页
Diagnostic Imaging & Interventional Radiology
关键词
肝移植
肺
真菌性感染
X线摄影
体层摄影术
X线计算机
Liver transplantation
Lung
Fungal infection
Radiography
Tomography, X-ray computed
