HRCT在诊断肝移植术后巨细胞病毒肺炎中的临床价值

目的探讨HRCT(High-resolution CT)在诊断肝移植术后巨细胞病毒(CMV)肺炎的临床价值。方法收集11例肝移植术后确诊为CMV肺炎患者的HRCT,由两名放射科医生统计分析病灶的形态及分布特征。结果毛玻璃影10例,多发结节8例,斑片状实变影4例。100%(11/11)患者肺内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。100%(11/11)例病变均累及双肺,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。结论肝移植术后患者肺部病变的HRCT表现为双肺混合存在的毛玻璃影、多发结节及斑片实变影时,提示肺内病变为CMV肺炎的可能。

The Value of HRCT in Diagnosis of Cytomegalovirus Pneumonia after Liver Transplantation

Objective To discuss the value of HRCT（High-resolution CT） in the diagnosis of cytomegalovirus pneumonia after liver transplantation. Methods The HRCT appearances of 11 patients with cytomegalovirus pneumonia after liver transplantation were retrospectively analyzed. Results 10 cases of ground-glass opacification, 8 cases of multiple nodules and 4 cases of air space consolidation were seen in 11 patients. A combination of ground-glass opacities, nodules, and areas of air-space consolidation were shown in 100%（ 11/11） patients.4 cases of ground-glass opacity and nodules, 3 cases of ground-glass opacity and air-space consolidation,l case of air-space consolidation and nodules and 3 case of grotmd-glass opacity, air-space consolidation and nodules were identified. Bilateral abnormalities were seen in all patients. Lesions were distributed in peripheral and internal zones lungs in 9 cases. Lesions only in peripheral zone of lungs and in internal zone of lungs were demonstrated in 3 cases respectively. Lesions in lower lobe, medial lobe and upper lobe were revealed in 11, 10 and 9 cases respectively. Conclusion A combination of ground- glass opacities, nodules, and areas of air-space consolidation were the most common HRCT appearances of cytomegalovirus pneumonia after liver transplantation and could be the evidences of diagnosis of cytomegalovirus pneumonia.