造血干细胞移植术后肺部感染的多层螺旋CT表现  

The multislice CT performance of pulmonary infection after hematopoietic stem cell transplantation

作　　者：邓东[1] 陈明东[1] 张小波[1] 周欣可[1] 

机构地区：[1]广西医科大学第一附属医院放射科,广西南宁530021

出　　处：《实用放射学杂志》2014年第11期1810-1813,共4页Journal of Practical Radiology

摘　　要：目的探讨造血干细胞移植（HSCT）术后肺部感染的多层螺旋CT（MSCT）表现。方法临床证实的HSCT术后肺部感染192例患者，分析有完整胸部CT资料的69例各时期病原体种类及CT表现。结果（1）HSCT术后肺部感染69例在术后早期（30d内）、中期（31～100d）、后期（100d以后）3个时间段的构成比分别为55．1％、24．6％、20．3％。细菌、真菌及混合感染多发生于早期，分别占78．6％、52．6％、56．7％；病毒感染多发生在中期，占66．7％；后期细菌、真菌、病毒及混合感染分别占14．3％、10．6％、33．3％、26．7％。（2）CT特征：细菌感染以实变影（7／14）及磨玻璃影（6／14）最常见；真菌感染以结节或肿块（15／19）最常见；病毒感染以磨玻璃影（3／6）最常见；结核均为混合感染，以结节（3／5）及多发实变影（2／5）常见；混合感染以磨玻璃影（15／30）及结节或肿块影（15／30）最为常见。在各病原体感染中除真菌感染出现征象的差异具有统计学意义（P〈0．05）外，其他无统计学意义（P〉0．05）。结论HSCT术后肺部感染高峰为术后早期；细菌、真菌及混合感染多发生于早期；CT对于HSCT术后肺部感染的诊断具有重要价值。Objective To investigate the MSCT performance of lung infection after hematopoietic stem cell transplantation （ HSCT）and to evaluate its clinical value. Methods 192 patients with pulmonary infection after HSCT confiremed by clinical materials were retrospectively studied. Pathogens and CT findings in different phases of 69 cases with complete chest CT examination materials were analyzed. Results （1） In 69 cases, the constituents ratio of postoperative HSCT pulmonary infection were 55.1% （early phase, within 30 days）, 24. 6% （medium phase, between 31 to 100 days）, and 20. 3% （late phase, after 100 days ）. The bacteria, fungal and mixed infection occurred in the early phase, accounted for 78.6%, 52.6%, and 56.7%, respectively. Virus infections occured in the midterm phase, accounted for 66.7% ; bacterial, fungal, virus and later mixed infection occurred late phase, accounted for 14.3%, 10.6%, 33.3% （2/6）, 26.7%, respectively. No pathogen was dominant. （2） CT features： the most common CT findings of the bacterial infection were consolidation （7/14 ） and ground glass shadow （6/14）. The most common CT manifestation of fungal infections were nodules or masses （15/19）; The most common CT performance of Virus infection was ground glass shadow （3/6） ; The most common CT performance of Tuberculosis were the nodules （3/5） and multiple opacities （2/5）. The most common CT manifestation of mixed infection were ground glass （15/30）and nodule and mass shadow （15/30）. There was statistically significant difference in fungal infection （P〈0.05）, the other had no statistical significance （ P〉0.05）. Conclusion The peak of pulmonary infection after HSCT is in the early phase, which includes bacteria, fungal and mixed infections. And CT is valuable to the diagnosis of pulmonary infections after HSCT.

关 键 词：肺 肺感染 造血干细胞移植 计算机体层成像 

分 类 号：R563.1[医药卫生—呼吸系统] R814.42[医药卫生—内科学]