肾移植术后肺部感染的影像学分析

目的：探讨肾移植术后并发肺部感染的X线、CT表现及分类，旨在提高对本病的诊断水平。材料与方法：回顾性分析108例肾移植患者并取具有代表性的27例，其中26例摄有胸部X线平片；单纯CT扫描1例；8例同时行胸部X线及CT检查。结果：粟粒型肺结核表现16例，其中4例合并纵隔淋巴结结核；X线、CT示双肺野广泛分布细小结节状的密度增高影，分布较均匀，密度及大小不均匀，3例病人CT显示双下肺内病灶有部分融合；霉菌性肺炎4例；表现为小结节状、斑片状及棉团状度增高影并有部分融合为特征，1例并发有少量胸腔积液；巨细胞病毒、绿脓杆菌及其它病菌感染7例；主要表现为大片状及斑片状融合实变影并不按肺叶、肺段分布。结论：X线及CT检查是诊断肾移植术后肺部感染的主要方法，影像学上部分有其特征性且可做出明确诊断。

The Imaging Analysis of Postoperative Pulmonary Infection of Renal Transplantation

Purpose:To study the X-ray and CT finding of postoperative pulmonary infection of renal transplantation,to improve the diagnostic.Materials and Methods:108 cases with renal transplantation were analysed retrospectively and 27 cases with representative were taken out,including 26 cases with radiography and only 1 case with CT scan.There were 8 cases with both X-ray radiography and CT scan.Results:16 cases with miliary pulmonary tuberculosis in which there were 4 cases incorporating mediastinal lymphoid tuberculosis displayed military high density image with widespread distribution in bilateral lung field,distribution homogeneity,density and shape nonhomogeneity.of 3 cases in CT displayed partial fusion on focus in bilateral lower lung. 4 cases with pulmonary mycotic infection displayed high density image with military,small patchy,ball and partial fusion.of 1 case incorporated hydrothorax in small amount.7 cases with cytomegalovirus infection,pyocyanic infection and others pathogenic infection displayed small and large patchy fusional consolidation,distributing not to according to segmental and lobe of lung.Conclusion:Radiography and CT scan were the main ways to diagnose postoperative pulmonary infection of renal transplantation which were partly characteristic in X-ray and CT and diagnosed clearly sometimes.