异基因造血干细胞移植后晚期非感染性肺部并发症的CT表现  

CT imaging features of late-onset noninfectious pulmonary complications after allogeneic hematopoietic stem cell transplantation

作　　者：杨硕[1] 霍天龙[1] 郝传玺[1] 赖云耀[1] YANG Shuo;HUO Tianlong;HAO Chuanxi;LAI Yunyao(Department of Radiology,Peking University People's Hospital,Beijing 100044,China)

机构地区：[1]北京大学人民医院放射科,北京100044

出　　处：《实用放射学杂志》2023年第1期41-44,共4页Journal of Practical Radiology

摘　　要：目的 探讨异基因造血干细胞移植(allo-HSCT)后晚期非感染性肺部并发症(LONIPC)的影像学表现.方法 收集63例allo-HSCT后LONIPC患者的胸部CT,分析其影像学特征.结果 63例患者中,闭塞性细支气管炎综合征(BOS)45例,典型特征为空气潴留,支气管壁增厚、支气管扩张、磨玻璃影是常见征象;机化性肺炎(OP)8例,多表现为磨玻璃影、实变影,病变以支气管血管束周围分布为主,3例表现为线状影,3例多浆膜腔积液.移植后淋巴组织增殖性疾病(PTLD)7例,累及肺部表现为肺部单发或多发结节,边界清楚,坏死少见.胸腔漏气综合征(TALS)10例,表现为纵隔气肿、间质气肿、皮下气肿及气胸.结论 allo-HSCT后LONIPC具有某些影像学特征性表现,但存在小气道阻塞严重时BOS无典型空气潴留、OP早期线状影发生率低等非典型影像学表现,因此影像结合临床对诊断、评估病情有重要意义.Objectivee To investigate imaging features of late-onset noninfectious pulmonary complications(LONIPC)after allogeneic hematopoietic stem cell transplantation(allo-HSCT).Methods Chest CT of 63patients with LONIPC after allo-HSCTwere collected and their imaging features were analyzed.Results Among 63 patients,imaging features of bronchiolitis obliterans syndrome(BOS)(n=45)were air trapping,bronchial wall thickening,bronchiectasis,and ground-glass opacity.Imaging features of organizing pneumonia(OP)(n=8)were ground-glass opacity,consolidation which distributed around bronchovascular bundles mostly,and 3 cases presented as linear opacities.3 cases showed multiple serous effusion.Imaging features of post-transplant lymphoproliferative disease(PTLD)(n=7)were single or multiple well-defined lung nodules withrare necrosis.Thoracic air-leak syndrome(TALS)(n=10)showed mediastinal emphysema,interstitial emphysema,subcutaneous emphysema and pneumothorax.Conclusion LONIPC after allo-HSCT have some characteristic imaging features.However,there are atypical imaging findings including no air trapping in BOS with serious obstruction of small airway,and low incidence of linear opacities in early stage of OP,et al.Imaging features combined with clinical symptoms can help for diagnosis and evaluation of the disease.

关 键 词：造血干细胞移植 晚期 非感染性肺部并发症 计算机体层成像 

分 类 号：R622[医药卫生—整形外科] R563[医药卫生—外科学] R814.42[医药卫生—临床医学]