双相薄层MDCT诊断造血干细胞移植术后气体潴留

Biphasic thin slice multi-detector CT in diagnosis of air-trapping signs in patients after hematopoietic stem cell transplantation

目的探讨双相薄层MDCT诊断造血干细胞移植术(HSCT)后闭塞性细支气管炎综合症(BOS)的价值。方法回顾性分析HSCT后29例疑似BOS患者双相薄层MDCT表现和肺功能检查(PFT)结果,对呼气相MDCT气体潴留情况、双相MDCT表现进行分级,并进行统计学分析。结果呼气相MDCT发现气体潴留23例,PFT分级在BOS-p(隐匿级)以上者12例,呼气相MDCT与PFT对气体潴留的检出阳性率差异无统计学意义(P>0.05);所有肺功能BOS-p级病例均有呼气相CT气体潴留表现;呼气相CT较PFT能筛查出更多异常病例;气体潴留常发生于双肺下叶和背侧。结论对于移植后出现BOS临床表现的患者,双相薄层MDCT可作为首选影像学检查方法。

Objective To observe the value of biphasic thin slice multi-detector CT（MDCT） in diagnosis of suspected bronchiolitis obliterans syndrome（BOS） after hematopoietic stem cell transplantation（HSCT）.Methods Biphasic thin slice MDCT manifestations and the results of pulmonary function tests（PFT） of 29 suspected BOS patients after HSCT were analyzed.The air-trapping signs of expiratory MDCT and biphasic phase MDCT manifestations were graded and compared statistically.Results Expiratory MDCT showed air-trapping in 23 patients,while PFT found 12 patients that above BOS-p（preclinical stage）.There was no statistical difference of positive rate between expiratory MDCT and PFT in detecting air-trapping（P0.05）.All patients with PFT above BOS-p level had air-trapping signs in expiratory MDCT.Expiratory MDCT could detect more abnormal than PFT.Gas retention was usually found in lower lobe and the back of lung.Conclusion For patients with clinical manifestations of BOS after HSCT,biphasic thin slice MDCT can be used as the first imaging examination.