肝移植术后巨细胞病毒肺炎的高分辨率CT表现

目的 探讨肝移植术后巨细胞病毒(CMV)肺炎的高分辨率CT(HRCT)表现,提高对其认识水平.方法 回顾性分析11例肝移植术后CMV肺炎的HRCT表现.结果 毛玻璃影10例,多发结节8例,斑片状实变影4例.所有病例见到多种形态病灶共同存在:毛玻璃影与多发结节4例,毛玻璃影与实变影3例,实变影与多发结节1例,毛玻璃影、实变影与多发结节三者共同存在3例.所有病变均累及双肺,9例病灶分布于肺内外带,仅分布于外带和内带各3例.病变累及下叶11例,累及中叶与上叶分别为10例、9例.4例胸膜增厚,3例少量胸腔积液和1例少量心包积液.所有病例均未见到肺门及纵隔肿大淋巴结.结论 肝移植术后CMV肺炎的HRCT表现主要为双肺混合存在的毛玻璃影、多发结节及斑片实变影,这些征象可作为诊断肝移植术后CMV肺炎的重要依据.     

脓肿型分枝杆菌肺部感染胸片和CT表现

目的：探讨脓肿型分支杆菌病的胸部X线和CT影像学表现。方法：回顾性分析18例经临床确诊为脓肿型分枝杆菌感染患者的X线、CT表现。结果：胸片异常征象：斑点状、细网状阴影16例（89%,16/18）,空洞8例（44%,8/18）,肺叶体积缩小8例（44%,8/18）,实变4例（22%,4/18）,支气管扩张8例（44%,8/18）。CT异常征象：支气管扩张12例（66.7%,12/18）,其中表现为柱状支气管扩张9例（50%,9/18）,囊状支气管扩张5例（27.8%,5/18）,静脉曲张型支气管扩张3例（16.7%,3/18）;直径小于10mm结节17例（94.4%,17/18）,树丫征15例（83.3%,15/18）;直径大于10mm结节13例（72.2%,13/18）,肺叶实变6例（33.3%,6/18）,段或亚段实变9例（50%,9/18）,空洞9例（50%,9/18）,肺体积缩小7例（38.9%,7/18）。结论：脓肿型分枝杆菌感染的胸片和CT表现主要为小结节样斑片状、细网状影、支气管扩张和空洞形成。     

肺炎型肺泡癌增强 CT 扫描及CT 导引下活检的临床应用

目的：探讨肺炎型肺泡癌(BAC)的 CT 表现特点及 CT 导引穿刺活检的应用价值。方法回顾分析病理证实的14例肺炎型 BAC 的影像学特征。结果14例肺炎型 BAC 中,实变肺组织内支气管充气征10例(71.4%),实变肺组织内蜂房状气腔或空洞征5例(35.7%),实变区周围呈现磨玻璃密度影及多发结节影5例(35.7%)；增强 CT 扫描实变区可见混杂的低密度区内血管造影征11例(78.6%),平均达峰时间为90 s,时间-密度曲线呈速升缓降型9例(64.2%)。结论CT 平扫表现肺段、叶性实变区内蜂窝状气腔及空洞、血管造影征、枯树枝征及周围多发腺泡结节及磨玻璃密度区、增强扫描实变区可见血管造影征,时间-密度曲线呈速升缓降型是肺炎型 BAC 的主要特点；CT 引导肺穿刺活检是较理想的确诊手段,二者结合可以大大提高早期诊断率。     

肺继发性淋巴瘤的CT多样性

目的：探讨肺继发性淋巴瘤的CT表现特征，以提高诊断正确率。材料和方法：回顾性分析临床或病理证实的26例肺继发淋巴瘤的CT征象，其中15例为非霍奇金淋巴瘤（NHL），11例为霍奇金病（HD）。本研究采用GE Hispeed CT／i，10例平扫，16例直接增强扫描。结果：CT表现多样：肺内毛玻璃样影（NHL 13vs HD6）；单发或多发肿块结节及肿块样实变（NHL 10vs HD8），其中仅HD组肿块中有4例病灶密度不均匀，5例见毛玻璃样晕症；黍粒样结节（NHL1）；支气管血管束增粗（NHL 1vs HD1）；肺门纵隔淋巴结肿大（NHL 9vs HD8）；胸膜侵犯（NHL 5vs HD2）；心包累及（NHL 2vs HD1）；常为多个征象合并出现（NHL 12vs HD5）。可分为以下四个类型：肺炎肺泡型（NHL 3vs HD1），肿块（结节）型（NHL 2vs HD2），黍粒型（NHL1），混合型（NHL 12vs HD5）。结论：多样性为肺继发性淋巴瘤的特点，不均匀的肿块或伴有病灶周围的毛玻璃样晕症多见于HD，对诊断可能有帮助。     

Castleman病多系统病变的CT表现

目的 分析Castleman病（CD）多系统病变的CT表现特征,提高对本病各系统受累的影像学认识。方法 选取31例经病理确诊为Castleman病的CT图像资料,其中单中心型（UCD）17例,均为透明血管型（HV）;多中心型（MCD）14例,均为浆细胞型（PC）。结果 17例UCD位于颈部3例,胸部9例,腹部5例,CT表现为单发均质或主体均质等密度类圆形肿物,14例增强后肿物呈均质或主体均质明显强化。4例出现结外器官肺异常,3例表现为肺内小结节影,1例呼吸气相HRCT两肺表现为闭塞性细支气管炎。14例MCD均可见全身多发淋巴结肿大,11例增强扫描显示肿大淋巴结均质强化;其中淋巴结轻度强化7例,中度和明显强化各2例。14例MCD中,12例出现结外器官组织异常,其中8例出现肺部异常,7例肝脾肿大,4例出现浆膜腔积液;肺部异常表现为两肺小叶中心分布小结节影8例,1～2 cm大结节影2例;其他征象包括：磨玻璃密度影、小叶间隔增厚和索条影各4例,斑片状实变3例,囊腔2例,血管支气管束增粗1例。结论 CD除了淋巴结外,还累及结外器官,具体CT表现与CD的病理分型有关。     

AIDS患者巨细胞病毒感染的肺部HRCT表现

目的探讨AIDS并发巨细胞病毒(cytomegalovirus,CMV)感染肺部HRCT表现。方法回顾性分析2015年1月~2015年10月间确诊AIDS合并CMV肺炎患者19例,分析胸部HRCT纵隔窗及肺窗征象。结果 19例CMV肺炎患者肺内见磨玻璃斑片影者16例,微结节影5例;小叶间隔增厚7例;部分肺实变者6例;支气管扩张者2例;厚壁空洞影1例。肺内病变以多种形态混合多见,不同类型病变分布各有特点。其中,磨玻璃斑片影多对称分布,外周带重或弥漫分布为主,与隐孢子菌肺炎向心性分布不同。随访结果显示肺内病灶完全吸收者较少,15/17患者肺内有病变残留,并形成纤维索条影或间质纤维化。结论 CMV肺炎肺部CT表现多样,磨玻璃影分布特点及治疗后病变残留对于诊断有提示价值。     

儿童肺部真菌感染的影像诊断

目的探讨儿童肺部真菌感染的临床表现及影像特征,加强认识,提高疾病的早期诊断。方法回顾分析38例儿童肺部真菌感染的临床及影像资料。结果 38例患儿中胸片检查正常4例,肺部可见片影15例,结节影17例,分布于中下肺野中外带,空洞7例。胸部CT表现:肺实变28例,表现为弥漫的、密度均匀或不均匀的实变影,呈现贴近胸膜的宽基底尖端指向肺门的楔形改变,实变边缘模糊可见"晕征";两肺单发或多发3~10mm的结节影19例,结节周围有"晕征",结节内有含气透亮影9例;肺内出现单或多发空洞15例,空洞内有网格状高密度影9例,空洞表现为大小不等形态不规则的薄壁含气空腔,多无张力,其中3例于空洞内可见霉菌球样肺段或肺叶;气管和支气管受侵4例,表现为气管支气管增粗、破环、扭曲变形,管腔狭窄闭塞,气管支气管所支配的肺组织出现不张和肺气肿;CT增强扫描,实变肺组织和肺内结节不强化,周围可见扭曲变形的小血管强化。结论肺部真菌感染的病原学检出率较低,早期诊断困难,易导致延误治疗,儿童肺部真菌感染影像学具有一定的特征性表现,为临床及时治疗提供了有力的证据。     

侵袭性肺曲菌病CT诊断(附17例报告)

目的:探讨侵袭性肺曲菌病(IPA)的CT表现。方法:回顾性分析经手术、病理证实的17例侵袭性肺曲菌病CT表现。结果:17例中患糖尿病3例,白血病3例,淋巴瘤2例,骨髓瘤2例,肺结核2例,肺癌术后1例,肾移植后1例,红斑狼疮长期服用激素1例,类风湿性关节炎长期服用激素1例,未患其它疾病者1例。17例中病变近胸膜下呈楔形大片状实变阴影6例,其中3例两肺伴多发结节样阴影;病变呈团块状阴影6例,团块边缘较光整,其中3例团块影内见大小不等小空洞,2例团块有轻微分叶,1例团块边缘略有"晕征";病变呈多发小结节病灶和多发小斑片状影散在分布两肺3例,小结节病灶边缘有"晕征";多发小斑片状影散在分布两肺2例,密度低,边缘模糊,呈磨玻璃样表现。结论:侵袭性肺曲菌病CT征象主要为楔形实变、团块状影、多发结节影及小斑片状影,多发结节伴"晕征"时应提示侵袭性肺曲菌病可能。     

MSCT后处理技术对真菌性肺炎的诊断及鉴别诊断价值

目的：探讨多层螺旋CT薄层图像与MPR图像在诊断真菌性肺炎中的临床价值,提高对该病的诊断水平。方法：搜集45例具有完整临床、实验室检查、病理组织学及CT检查资料的肺部真菌感染病例,回顾性分析其常规CT图像、薄层图像及MPR图像的CT征象。结果：白色念珠菌感染12例,曲霉菌感染14例,隐球菌感染8例,毛霉菌感染5例,放线菌感染3例,马尔尼菲青霉菌感染3例。肺部真菌感染的CT表现如下：空洞为主型15例,表现为一个或几个肺叶内单发或多发大小不等空洞性病灶,部分空洞周围见“晕征”,部分空洞内呈典型“鸟巢征”;肺炎样实变或支气管肺炎样变16例,呈小片状或大片状阴影,见支气管充气征及周边密度趋淡即“晕征”;结节或肿块8例,结节或肿块可伴有空洞、“晕征”、毛刺或分叶征;曲菌球6例,呈圆形或椭圆形,并可见“新月征”。薄层CT图像结合MPR图像在显示“晕征”、磨玻璃影、网格、线样影及小结节等cT征象明显优于普通cT（P〈0．05）,其余征象无明显差异（P〉0．05）,但薄层cT结合MPR图像能更清楚地显示病灶范围。结论：多层螺旋CT薄层图像结合MPR图像有助于肺真菌感染的诊断,真菌性肺炎有一定相对特征性改变,掌握真菌性肺炎的CT表现特征,结合临床综合分析,可提高诊断准确性。     

肺炎型浸润性黏液腺癌的影像学表现并文献回顾

目的：分析肺炎型浸润性黏液腺癌（invasive mucinous adenocarcinoma,IMA）的影像学征象与临床病理学特征,提高对该病的诊断准确度。方法：回顾并分析23例经病理学检查证实的肺炎型IMA患者的临床与影像学资料,并结合病理学检查结果,总结该病的影像学特点。结果：23例肺炎型IMA患者,以咳嗽为症状发现13例,其中咳白痰6例。首诊误诊肺炎11例,其中2例首次计算机体层成像（computed tomography,CT）引导下穿刺活检病理学报告为炎症。多发病灶9例,单发14例;CT检查两肺外周分布为主16例,中心性分布2例,弥漫性分布5例;上叶3例,中叶3例,下叶17例。影像上,病变实性成分较少,斑片状实变影伴磨玻璃影23例（100.0%）,“充气支气管”征17例（包括“枯树枝”征11例）,“叶间裂膨隆”征6例;囊腔或空洞影15例;双肺或单肺伴发不规则结节7例;增强扫描示23例均呈轻中度强化,其中“血管造影”征有19例。23例患者均未见胸腔积液、淋巴结肿大及远处转移。病理学检查镜下可见沿肺泡壁排列的高柱状细胞,胞浆及肺泡腔内大量黏液（黏液湖）,细胞核轻度异型性。结论...     

High-resolution CT findings of respiratory syncytial virus pneumonia after bone marrow transplantation

OBJECTIVE: The aim of this study was to describe the high-resolution CT findings of respiratory syncytial virus pneumonia in 20 patients who had undergone allogeneic bone marrow transplantation. MATERIALS AND METHODS: The study included 20 consecutive patients who developed respiratory syncytial virus pneumonia after bone marrow transplantation and who had high-resolution CT of the chest performed within 24 hr after the onset of symptoms. The CT scans were reviewed by two chest radiologists who assessed the pattern and distribution of findings. RESULTS: Bone marrow transplantation was performed on 12 male and eight female patients ranging from 3 to 48 years old (mean age, 25 years) for treatment of various forms of leukemia (n = 12), severe aplastic anemia (n = 6), Fanconi's syndrome (n = 1), and paroxysmal nocturnal hemoglobinuria (n = 1). Sixteen patients (80%) had abnormal CT findings. The predominant patterns of abnormality on high-resolution CT scans were small centrilobular nodules (10/20, 50%), air-space consolidation (7/20, 35%), ground-glass opacities (6/20, 30%), and bronchial wall thickening (6/20, 30%). The abnormalities were distributed in the central and peripheral areas of the lungs in nine cases, only in the periphery in five cases, and only in the central regions in two cases. The abnormalities were bilateral and asymmetric in distribution in 13 patients, bilateral and symmetric in two patients, and unilateral in one patient. CONCLUSION: The most common high-resolution CT findings in patients with respiratory syncytial virus pneumonia after bone marrow transplantation consist of small centrilobular nodules and multifocal areas of consolidation and ground-glass opacities in a bilateral asymmetric distribution.     

重症及危重症甲型H1N1流感肺炎的影像表现

目的 探讨重症及危重症甲型H1N1流感病毒肺部感染的胸部影像表现.方法 回顾性分析18例甲型H1N1流感并发肺炎患者的临床及影像资料,将其分为重症组(11例)及危重症组(7例),所有患者均经胸部X线检查,其中2例行CT检查.结果 重症组11例,8例X线表现为双侧肺野中内带分布的、边缘模糊的小斑片和结节状阴影,3例X线表现为局灶性边缘模糊的片状阴影,其中1例胸部CT表现为右下肺大片实变影.危重症组7例,4例X线表现为双肺弥漫分布的磨玻璃密度阴影伴部分实变,其中1例出现胸颈部皮下气肿,1例胸部CT表现为双肺广泛分布的、沿支气管走行的斑片状磨玻璃密度影,双下肺结节状实变病灶和胸腔积液;其他3例表现为双侧肺野内大范围实变影.结论 甲型H1N1流感肺炎的影像表现包括重症患者肺内的结节样和斑片状阴影,危重患者肺内弥漫的支气管周围分布的磨玻璃密度灶和多灶性实变.     

Bronchiolitis obliterans organizing pneumonia: CT features in 14 patients

Bronchiolitis obliterans organizing pneumonia is a disease characterized by the presence of granulation tissue within small airways and the presence of areas of organizing pneumonia. We retrospectively reviewed the chest radiographs, CT scans, and biopsy specimens in 14 consecutive patients with proved bronchiolitis obliterans organizing pneumonia. Six patients were immunocompromised because of leukemia or bone-marrow transplantation. In all patients, 10-mm collimation CT scans were available. In 11 of the 14 patients, select 1.5-mm scans were obtained. The CT findings included patchy unilateral (n = 1) or bilateral air-space consolidation (n = 9), small nodular opacities (n = 7), irregular linear opacities (n = 2), bronchial wall thickening and dilatation (n = 6), and small pleural effusions (n = 4). All patients had areas of air-space consolidation, small nodules, or both. A predominantly subpleural distribution of the air-space consolidation was apparent on the radiographs of two patients and on CT scans of six. Pathologically, the nodules and the consolidation represented different degrees of inflammation in bronchioles, alveolar ducts, and alveoli. Although most of the findings were apparent on the radiographs, the CT scans depicted the anatomic distribution and extent of bronchiolitis obliterans organizing pneumonia more accurately than did the plain chest radiographs.     

白血病患者骨髓移植术后肺部并发症的CT诊断

目的探讨白血病患者骨髓移植术后肺部并发症的CT诊断。方法对30例白血病患者骨髓移植术后肺部并发症的CT表现进行回顾性分析。结果巨细胞病毒性肺炎可以表现为弥漫性实变、多发结节、毛玻璃改变、多发小片状影,以弥漫性实变为最多见(37.5%,3/8);真菌性肺炎主要表现为单发球形病灶(50.0%,4/8),其中3例病灶周围可见毛玻璃密度影;细菌性肺炎主要表现为单发片状影(50%,1/2);急性呼吸窘迫综合征(ARDS)主要表现为弥漫性实变(66.7%,2/3);肺水肿主要表现为支气管血管束增粗或网格状改变(66.7%,2/3);药物毒性反应可表现为弥漫性实变(50.0%,1/2)或网格状改变(50.0%,1/2);细支气管闭塞并机化性肺炎气管炎(BOOP)表现为多发结节状改变(50.0%,1/2)或毛玻璃密度改变(50.0%,1/2)。移植后3周内发生率最高的为真菌感染,移植后3~14周发生率最高的为巨细胞病毒性肺炎,移植后14周以后病例较少,主要为BOOP。结论综合分析CT表现对血病患者骨髓移植术后肺部并发症的诊断有较高价值。     

Squalene-induced extrinsic lipoid pneumonia: serial radiologic findings in nine patients.

PURPOSE: The purpose of this work was to demonstrate the initial and follow-up radiologic findings of squalene-induced extrinsic lipoid pneumonia. METHOD: Follow-up chest radiographs (n = 9) and high-resolution CT scans (n = 3) as well as initial radiographs (n = 9) and CT scans (n = 8) were obtained in nine patients with squalene-induced extrinsic lipoid pneumonia. The serial radiologic findings were analyzed retrospectively by three chest radiologists, focusing on the pattern and distribution of parenchymal abnormalities. RESULTS: The most frequent pattern of parenchymal abnormalities on chest radiograph was areas of ground-glass opacity (n = 9, bilateral 6), followed by consolidation (n = 7, bilateral 3) and poorly defined small nodules (n = 4, bilateral 2). The abnormalities were distributed in the right lower lung (n = 9), left lower lung (n = 6), and right middle lung (n = 6) zones. Initial CT scans (n = 8) demonstrated bilateral areas of ground-glass attenuation (n = 8), poorly defined centrilobular nodules (n = 8), crazy paving (n = 6), and consolidation (n = 3). The abnormalities were distributed in the right middle lobe (n = 8) and in both lower lobes (n = 5). Follow-up chest radiograph (n = 9) showed complete disappearance (n = 2) and decrease (n = 7) in the extent of the parenchymal abnormalities. Follow-up CT scans (n = 3) demonstrated decrease (n = 2) and no change (n = 1) in the extent of the abnormalities. CONCLUSION: Squalene-induced extrinsic lipoid pneumonia most commonly appears as areas of ground-glass attenuation mixed with poorly defined centrilobular nodules and crazy paving on CT, being distributed mainly in the right middle and both lower lobes. The lesions are indolent and remain after cessation of squalene ingestion.     

Lymphocytic interstitial pneumonia: thin-section CT findings in 22 patients.

PURPOSE: To assess the thin-section computed tomographic (CT) findings of lymphocytic interstitial pneumonia. MATERIALS AND METHODS: The study included 22 patients (five men, 17 women; age range, 24-83 years; mean age, 50 years) with biopsy-proved lymphocytic interstitial pneumonia. The CT scans were obtained by using 1-3-mm collimation and reconstructed by using a high-spatial-frequency algorithm. RESULTS: The predominant abnormalities consisted of areas of ground-glass attenuation and poorly defined centrilobular nodules present in all 22 patients and subpleural small nodules seen in 19 patients. Other common findings included thickening of bronchovascular bundles (n - 19), interlobular septal thickening (n = 18), cystic airspaces (n = 15), and lymph node enlargement (n = 15). Less common findings included large nodules, emphysema, airspace consolidation, bronchiectasis, architectural distortion, honeycombing, and pleural thickening. CONCLUSION: Lymphocytic interstitial pneumonia is characterized by the presence of ground-glass attenuation, poorly defined centrilobular nodules, and thickening of the interstitium along the lymphatic vessels. Lymph node enlargement is more common than previously recognized; it was seen in 68% of patients.     

Thin-section CT findings in 32 immunocompromised patients with cytomegalovirus pneumonia who do not have AIDS

OBJECTIVE: The aim of this study was to review the thin-section CT findings in 32 immunocompromised patients without AIDS who had proven Cytomegalovirus pneumonia. MATERIALS AND METHODS: The causes of immunocompromise included bone marrow (n = 25) or solid organ transplantation (n = 5) and corticosteroid therapy (n = 2). The patients included 16 men and 16 women ranging in age from 22 to 70 years (mean age, 43 years). The CT scans were retrospectively reviewed by two thoracic radiologists for the presence, appearance, and distribution of parenchymal abnormalities. RESULTS: Bilateral abnormalities were seen in all patients. Areas of ground-glass opacification were seen in 21 (66%) of 32 patients. Ground-glass opacification was the predominant CT feature in nine cases (28%). In 19 of 32 patients, ground-glass attenuation was associated with other abnormalities. Multiple nodules were identified in 19 patients (59%). Nodules were bilateral in 15 patients and unilateral in four patients. Nodules were the only CT finding in three patients (9%). Areas of air-space consolidation were identified in 19 patients (59%). Air-space consolidation was the only CT finding in one patient (3%). Other less common CT findings included thickening of the bronchovascular bundles (n = 7) and the tree-in-bud appearance (n = 4). Pleural effusions were seen in seven patients. CONCLUSION: The thin-section CT manifestations of Cytomegalovirus pulmonary infection usually consist of a mixture of patterns, most commonly ground-glass attenuation, areas of consolidation, and small nodules.     

Pulmonary candidiasis after hematopoietic stem cell transplantation: thin-section CT findings

PURPOSE: To retrospectively evaluate thin-section computed tomographic (CT) findings in hematopoietic stem cell transplant (ie, bone marrow transplant) patients with histopathologically proved pulmonary candidiasis. MATERIALS AND METHODS: Ethical approval was obtained from the institutional review board of each of the three institutions; informed consent was not required. The study included 17 hematopoietic stem cell transplant recipients with proved pulmonary candidiasis. Histopathologic specimens were acquired at transbronchial biopsy (n = 8), open lung biopsy (n = 6), and autopsy (n = 3). The patients included seven men and 10 women (age range, 20-62 years; mean age, 37 years). The thin-section CT scans were retrospectively reviewed by two thoracic radiologists for the presence, appearance, and distribution of parenchymal abnormalities. RESULTS: Multiple nodules were present in 15 (88%) patients, including centrilobular nodules and tree-in-bud pattern in seven (41%) patients. Nodules were bilateral in 12 patients and unilateral in three. An associated halo of ground-glass opacity was identified in five (33%) patients. Nodules were the only CT finding in five patients (29%). Areas of air-space consolidation were identified in 11 (65%) patients. Areas of ground-glass opacity were seen in six (35%) of 17 patients and were always associated with other abnormalities. Other less common CT findings included pleural effusion (n = 3), thickening of the bronchial walls (n = 2), and cavitation (n = 1). CONCLUSION: The most common thin-section CT findings of pulmonary candidiasis in hematopoietic stem cell transplant patients are multiple bilateral nodular opacities often associated with areas of consolidation.     

Lung diseases in patients with common variable immunodeficiency: chest radiographic, and computed tomographic findings

OBJECTIVE: To evaluate chest radiographic and computed tomographic (CT) findings of lung disease related to common variable immunodeficiency. METHODS: Thirty-five chest radiographs and 30 CT scans of 46 patients were assessed. Lung parenchymal abnormalities that were evaluated included airspace consolidation, ground-glass attenuation, nodules, bronchiectasis, and air trapping. RESULTS: On CT, ground-glass attenuation and nodules were the most frequent findings, observed in 60% (n = 18/30) and 83% (n = 25/30), respectively. Three major CT patterns were identified: airway disease (n = 13), nodules (n = 8), and parenchymal opacification (n = 6). All 13 patients with airway disease showed centrilobular opacities. One patient with peribronchial nodules showed lymphoid interstitial pneumonia, and 1 with randomly distributed nodules showed noncaseating granulomas. Patients with a CT pattern of parenchymal opacification showed lower lung predominance; surgical biopsies showed organizing pneumonia in 1 patient and lymphoid interstitial pneumonia with nonnecrotizing granulomas in another. CONCLUSIONS: Common variable immunodeficiency is associated with 3 major CT patterns: airway disease, nodules, and parenchymal opacification.     

Cytomegalovirus Pneumonia: High-Resolution CT Findings in Ten Non-AIDS Immunocompromised Patients

Objective

To describe the HRCT findings of cytomegalovirus (CMV) pneumonia in non-AIDS immunocompromised patients.

Materials and Methods

This retrospective study involved the ten all non-AIDS immunocompromised patients with biopsy-proven CMV pneumonia and without other pulmonary infection encountered at our Medical Center between January 1997 and May 1999. HRCT scans were retrospectively analysed by two chest radiologists and decisions regarding the findings were reached by consensus.

Results

The most frequent CT pattern was ground-glass opacity, seen in all patients, with bilateral patchy (n = 8) and diffuse (n = 2) distribution. Other findings included poorly-defined small nodules (n = 9) and consolidation (n = 7). There was no zonal predominance. The small nodules, bilateral in eight cases and unilateral in one, were all located in the centrilobular region. Consolidation (n = 7), with patchy distribution, was bilateral in five of seven patients (71%). Pleural effusion and bilateral areas of thickened interlobular septa were seen in six patients (60%).

Conclusion

CMV pneumonia in non-AIDS immunocompromised patients appears on HRCT scans as bilateral mixed areas of ground-glass opacity, poorly-defined centrilobular small nodules, and consolidation. Interlobular septal thickening and pleural effusion are frequently associated.