摘要
目的分析造血干细胞移植后侵袭性真菌肺部感染的CT表现及病程中的影像学变化及预后。方法回顾性分析27例白血病、淋巴瘤等恶性血液病患者进行造血干细胞移植后出现侵袭性真菌肺部感染后3个月～2年中出现胸部异常的多次CT影像表现。结果首诊胸部CT单发结节或肿块8例,双肺多发结节、肿块4例,肺内片状实变影6例,伴肺不张2例,单发结节状磨玻璃影2例,主要伴随征象包括晕征、树芽征、空洞、支气管气像及空气新月征等,15例患者抗真菌治疗后病灶有不同程度吸收,6例13个结节或肿块内出现空洞。6例患者治疗后病情加重,其中4例死于严重肺部感染及原发病。结论造血干细胞移植后侵袭性真菌性肺部感染CT表现以结节、肿块并伴有伴随征象常见。治疗后复查CT结节或肿块吸收较慢且病灶易出现空洞。
Objective To analyze dynamic pulmonary CT performance and prognosis of patients with invasive fungal disease(IFD)after hematopoietic stem cell transplantation(HSCT).Methods CT findings of 27 patients with malignant hematological diseases such as leukemia and lymphoma who developed invasive fungal pulmonary infection after hematopoietic stem cell transplantation were retrospectively analyzed.Results Single nodule or mass in chest CT was first diagnosed in 8 cases,multiple nodules and masses in both lungs in 4 cases,pulmonary consolidation in 6 cases,atelectasis in 2 cases,single nodular ground glass opacity in 2 cases.The main accompanying signs included halo sign,tree bud sign,cavitation,bronchial gas and air crescent sign.After antifungal treatment,the lesions were absorbed to varying degrees in 15 cases,and cavitation in 13 nodules or masses in 6 cases.After treatment,6 patients became worse,4 patients of them died of severe pulmonary infection and primary diseases.Conclusion Nodule or mass is the most common CT finding of pulmonary IFD after HSCT treatment.The absorption of nodules and masses was slow and could turn cavitation.
作者
宋巍
史克倩
王罡
SONG Wei;SHI Keqian;WANG Gang(Department of Radiology,The First People’s Hospital of Yunnan Province,Kunming Yunnan 650031,China;Department of Hematology)
出处
《中国继续医学教育》
2019年第11期78-80,共3页
China Continuing Medical Education
关键词
造血干细胞移植
真菌
肺部感染
体层摄影术
X线计算机
血液系统肿瘤
hematopoietic stem cell transplantation
fungal
pulmonary infection
tomography
X-ray computer
hematological malignancies
