造血干细胞移植术后肺部非感染性并发症的CT分析

CT Analysis of Pulmonary Noninfectious Complications Following Hematopoietic Stem Cell Transplantation

目的:探讨造血干细胞移植术(HSCT)后肺部非感染性并发症的CT诊断价值。方法:回顾性分析7例HSCT后伴肺部非感染性并发症患者的临床、实验室以及肺部CT检查及治疗后复查资料。结果:7例中CT显示柱状支气管扩张3例,弥漫性马赛克样磨玻璃影2例,条状或分叉状影2例,小叶中心结节融合片状影2例,肺气肿2例,不规则实变1例,气胸1例,双侧胸腔积液1例。3例支气管扩张均合并肺气肿或气胸。弥漫马赛克样磨玻璃病变2例于抗免疫治疗后短期内好转,其中1例合并肺部不规则实变。结论:HSCT术后肺部非感染性并发症常见且致命.其CT表现具有一定特点,短期内复查CT并结合临床往往可做出准确诊断。

Objective： To investigate the value of CT in pulmonary noninfectious complications following hematopoietic stem cell transplantation （HSCT）. Methods.. The clinical and laboratory data as well as pulmonary CT images of seven patients with pulmonary complications following HSCT were retrospectively analyzed. Results： Of the seven patients with HSCT,the CT findings of pulmonary non-infectious complications included： tubular bronchiectasis （n = 3）, diffuse mosaic patchy ground glass opacities （n = 2）, linear or branching opacities （n= 2）, confluent centrilobular nodules （n = 2）, emphysema （n=2）,and irregular patchy consolidation, pneumothorax and pleural effusion for 1 patient each. 3 patients showed bronchiectasis associated with emphysema or pneumothorax, 2 patients who had diffuse mosaic patchy ground glass opacities regressed after short term anti-immunotherapy,one of these two had associated irregular patchy consolidation. Conclusion： Pulmonary noninfectious complications following HSCT are common and could be fatal,CT findings were characteristic to a certain extent,short term follow-up CT in combination with clinical findings are important for accurate diagnosis.