肾移植后严重肺合并症的CT诊断

目的 探讨肾移植术后严重肺感染的CT表现。资料与方法 6例肾移植患者术后大剂量使用了免疫抑制剂，术后3个月左右发生了严重的肺感染。6例均进行了胸部X线和螺旋CT检查，其中巨细胞病毒肺炎5例，肺炎克雷白杆菌肺炎1例。首次CT扫描在X线检查后的第2d进行。结果 6例中，4例首次X线检查阴性。全部病例CT检查均发现异常，最常见的CT表现是：（1）两肺多发片状影；（2）弥漫分布边界不清的小结节影；（3）磨玻璃样高密度影；（4）片状实变；（5）肺间质增厚和胸腔积液。结论 在肾移植术后肺感染患者中，CT能较早地发现肺部异常，尤其是在X线检查阴性时，应尽早进行CT检查。

CT Diagnosis of Severe Pulmonary Infection after Renal Transplantation

Objective To discuss CT features of a group of severe pulmonary infection after renal transplantation.Materials and Methods 6 patients with severe pulmonary infection were accepted by large dosage of immunosuppressive drugs after renal transplantation in 3 months, All patients were performed X-ray and spiral CT scanning, including 5 cases with cytomegalovirus(CMV), 1 case with Neumann's bacillus pneumonia. The first time CT scan was performed on the second day after X-ray examination.Results Among the 6 patients, 4 cases were negative in the first time X-ray examination, but abnormalities were found in all patients on CT scanning. The most frequent CT findings were: (1) multiple bilateral patchy. (2) Poorly defined diffusing small nodules. (3) Ground glass opacity. (4) Consolidation with patchy. (5) Pleural effusion and lobular interstitium thickness.Conclusion CT can detect pulmonary abnormalities of patients after renal transplantation in early stage, in the case of suspected pulmonary infection, CT scanning should be performed as early as possible, especially when X-ray results are negative.