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目的分析异基因造血干细胞移植后慢性期肺部病变的CT表现及治疗后变化的影像特点。资料与方法对近4年行异基因造血干细胞移植后生存期超过3个月的受者中发现胸部异常的35例患者的CT影像资料进行回顾性分析。结果移植后慢性期胸部CT表现:9例呈局限叶或多叶的磨玻璃样改变,同时伴网状或网织结节状影;16例为散在胸膜下肺内团片状或斑点状影,伴支气管气像5例;5例表现为胸膜下肺内多发球形不均匀密度影与厚壁空洞并存;4例表现为下肺间质条索状密度影;1例为肺气囊。治疗过程中累计出现19个空洞,2例纵隔气肿,2例气胸,治疗时间约2～6个月。结论异基因造血干细胞移植后慢性期肺部病变以肺间质病变为主,实变病灶好发于胸膜下且易合并真菌感染出现空洞,上肺较下肺好发。
Objective To analyze the CT features of chronic pulmonary lesions after allogeneic hematopoietic stem cell transplantation and the imaging features after the treatment. Materials and Methods Retrospective analysis was performed on the CT images of 35 patients with abnormal thorax in those who lived more than 3 months after allogeneic hematopoietic stem cell transplantation in recent 4 years. Results Posttransplantation chronic chest CT findings: 9 cases showed limited or multilobate ground glass changes, accompanied by reticular or reticular nodular shadow; 16 cases were scattered in the subpleural lung cytoplasm or patchy shadow , With 5 cases of bronchial air bronchogram; 5 cases showed subpleural multiple intracranial uneven spherical density and thick wall empty coexistence; 4 cases showed inferior pulmonary interstitial cord-like density; 1 case of lung balloon. During the treatment, there were 19 holes, 2 cases of mediastinal emphysema, 2 cases of pneumothorax, and the treatment time was about 2 to 6 months. Conclusions Allogeneic hematopoietic stem cell transplantation in chronic lung disease mainly interstitial lung disease, consolidation lesions occur in the subpleural and easy to merge with fungal infection appear hollow, the upper lung more than the lower lungs.