异基因造血干细胞移植后慢性期肺部病变的CT分析  

Analysis CT Features of Lung Lesion After Allogeneic Hematopoietic Stem Cell Transplantation

作　　者：王永安[1] 赵双全[1] 章绪辉[1] 陈盛亭[2] 罗良平[3] 

机构地区：[1]暨南大学附属第一医院放射科,广州510630 [2]暨南大学附属第一医院血液科,广州510630 [3]暨南大学附属第一医院影像中心,广州510630

出　　处：《临床放射学杂志》2009年第2期175-179,共5页Journal of Clinical Radiology

摘　　要：目的分析异基因造血干细胞移植后慢性期肺部病变的CT表现及治疗后变化的影像特点。资料与方法对近4年行异基因造血干细胞移植后生存期超过3个月的受者中发现胸部异常的35例患者的CT影像资料进行回顾性分析。结果移植后慢性期胸部CT表现:9例呈局限叶或多叶的磨玻璃样改变,同时伴网状或网织结节状影;16例为散在胸膜下肺内团片状或斑点状影,伴支气管气像5例;5例表现为胸膜下肺内多发球形不均匀密度影与厚壁空洞并存;4例表现为下肺间质条索状密度影;1例为肺气囊。治疗过程中累计出现19个空洞,2例纵隔气肿,2例气胸,治疗时间约2～6个月。结论异基因造血干细胞移植后慢性期肺部病变以肺间质病变为主,实变病灶好发于胸膜下且易合并真菌感染出现空洞,上肺较下肺好发。Objective To analyze the lung＇s CT appearances and its changes after treatments in the chronic phase with heterogenic haemopoietic stem cell transplantation. Materials and Methods By retrospectively analyzing cases received heterogenic haemopoietic stem cell transplantation with hfe span surpassed three months after the treatment in recent four years, we found 35 cases had abnormalities in chest. Results 9 cases were found with groud glass opacity alteration in the single or muhiple lung lobes and accompanied with reticulate or nodose shadows. 16 cases were revealed discrete patchy or mottling shadows in the lung below membrana pleuralis, among them there were 5 cases presented air bronchogram. 5 cases displayed both polyglobular, inhomogeneous dense shadows and thick-walled lung cavity. 4 cases displayed density like trabs in the lung interstitium. 1 case displayed single pneumatoceles. There were total 19 cavities, 2 mediastinal emphysema, 2 aeropleura in the two-six months treatment course. Conclusion Lung interstitial lesions are the main changes after heterogenic haemopoietic stem cell transplantation. The consolidation predilected the lung tissues below the membrana pleuralis, easily complicated fungous infection and resulted in cavity. These changes prefered upper lung to the lower.

关 键 词：造血干细胞移植 放射摄影术 肺炎 

分 类 号：R733[医药卫生—肿瘤] R816.4[医药卫生—临床医学]