腹部器官(肝、肾)移植术后卡氏肺囊虫肺炎的影像学表现——两例报告及文献复习

Imaging manifestations of pheumocystis carinii pheumonia in patients after liver and renal transplantation(Report of 2 case)

目的探讨肝、肾移植术后并发卡氏肺囊虫肺炎的影像学表现。方法报告2例经实验室病理检查证实的肝、肾移植术后并发卡氏肺囊虫肺炎患者,就其影像学所见并复习文献进行分析、讨论。结果首次胸片或CT示两中下肺野透亮度低,弥漫性网状及小点、片状影;一系列随访示双肺野透亮度进一步减低,呈毛玻璃状改变,肺野小叶间隔增粗,略呈网格状,继之出现多发斑片状及大小不等结节病灶并逐渐增大,部分病灶内空洞形成。结论卡氏肺囊虫肺炎的影像表现呈多样性,X线及CT影像对本病的诊断有重要价值,最终确诊有赖于病理检查。

Objective To study the imaging features of secondary pneumocystis carinii pneumonia（PCP） in patients after Liver and renal transplantation. Methods Two cases pathologically proved PCP after liver renal transplantation were collected. The imaging features were discussed and the literature were reviewed. Results On the orginal plain chest film or CT scans, the lesions were bilateral,presenting as decrease in the lung densite, diffuse reticulo-tittle-densities and patchy shadows. A series of follow-up showed decrease in the lung densite were more, ground-glass opacification, reticular shadows,afterwards showed signs of multiple patchy shadows and noduses varying in size, increasing gradually. There were cavity formation in noduses. Conclusion PCP may exhibit a variety of imaging manifestations. Plain chest film is of value for the diagnosis of the disease although a definitive diagnosis depends on pathological evidence.