Acta radiologica (Stockholm, Sweden : 1987) · 2000
Pulmonary disease in liver transplant recipients. Spectrum of CT features.
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Knollmann F D, Mäurer J, Bechstein W O, Vogl T J, Neuhaus P, Felix R
Аннотация
PURPOSE: To determine the features of pulmonary disease in liver transplant recipients by CT.
MATERIAL AND METHODS: Of 792 patients, 102 were referred to thoracic CT 3-2093 days after the transplantation procedure (median 107 days). All CT studies were retrospectively analyzed and correlated with clinical, microbiological, serological and histopathological findings.
RESULTS: Eighty-eight of 102 patients (86%) had an abnormal CT. In 25 patients (25%), an elevated right hemidiaphragm, basal atelectasis and small effusions were the only abnormalities. Fourty-one patients (40%) displayed an infiltrate and 13 (13%) a mass lesion. Evidence of cytomegalovirus (CMV) infection was found in 20 patients. CMV pneumonia was suggested by an interstitial pattern of pneumonia on CT (n=13). Pneumocystis carinii pneumonia was highlighted by peribronchovascular infiltrates (n=5/8), bacterial pneumonia (n=24) including legionellosis (n= 13) by bilateral effusions (n=14) and lobar consolidation (n= 13). In 7/41 patients (17%) with both clinically apparent pulmonary disease and CT signs of pneumonia, no pathogen could be detected. Neoplastic disease was mostly due to tumor recurrence (n=6).
CONCLUSION: Thoracic CT of liver transplant recipients aids in detecting and classifying both infectious and neoplastic complications.
MATERIAL AND METHODS: Of 792 patients, 102 were referred to thoracic CT 3-2093 days after the transplantation procedure (median 107 days). All CT studies were retrospectively analyzed and correlated with clinical, microbiological, serological and histopathological findings.
RESULTS: Eighty-eight of 102 patients (86%) had an abnormal CT. In 25 patients (25%), an elevated right hemidiaphragm, basal atelectasis and small effusions were the only abnormalities. Fourty-one patients (40%) displayed an infiltrate and 13 (13%) a mass lesion. Evidence of cytomegalovirus (CMV) infection was found in 20 patients. CMV pneumonia was suggested by an interstitial pattern of pneumonia on CT (n=13). Pneumocystis carinii pneumonia was highlighted by peribronchovascular infiltrates (n=5/8), bacterial pneumonia (n=24) including legionellosis (n= 13) by bilateral effusions (n=14) and lobar consolidation (n= 13). In 7/41 patients (17%) with both clinically apparent pulmonary disease and CT signs of pneumonia, no pathogen could be detected. Neoplastic disease was mostly due to tumor recurrence (n=6).
CONCLUSION: Thoracic CT of liver transplant recipients aids in detecting and classifying both infectious and neoplastic complications.
Предметные рубрики MeSH
AdolescentAdultAgedAnalysis of VarianceAspergillosisBronchographyChi-Square DistributionCytomegalovirus InfectionsFemaleFollow-Up StudiesHumansLegionellosisLiver NeoplasmsLiver TransplantationLung DiseasesLung Diseases, FungalMaleMiddle AgedNeoplasm Recurrence, LocalPleural EffusionPneumonia, BacterialPneumonia, PneumocystisPneumonia, ViralPulmonary AtelectasisRetrospective StudiesTomography, X-Ray Computed