期刊文献+

肾移植术后肺部真菌感染的CT表现 被引量:2

Value of spiral CT in diagnosis of pulmonary invasive infections with fungi after renal transplantation
下载PDF
导出
摘要 目的分析肾移植术后肺部侵袭性真菌感染的CT表现,以期对临床治疗方法的选择及调整提供帮助。方法回顾分析我院2008~2010年肾移植术后肺部侵袭性真菌感染52例,所有病例按照临床现行通用标准进行确诊,并分析其CT图像。结果 52例患者中,CT表现为结节、肿块影27例,空洞影11例,晕征(halo)16例,空气新月征(air-crescent sign)9例,曲菌球形成4例,粟粒样影2例,不规则渗出、实变影23例,胸腔积液4例,肺门或纵隔淋巴结肿大5例。结论肾移植术后肺部真菌感染CT表现多样,缺乏特异性。当病灶表现为结节、肿块影、尤其出现特征性的空气新月征及晕征时,高度提示曲霉菌感染存在的可能;若呈磨玻璃样等间质性肺炎的改变,则难以与肺部其他类型的感染鉴别。 Objective To analyze the CT manifestations of pulmonary invasive infections with fungi after renal transplantation in order to provide certain help to the selection and the adjustment of clinical treatment. Methods A retrospective analysis was made in the clinical data of 52 patients with pulmonary invasive infections with fungi after renal transplantation from 2008 to 2010. All the cases were finally diagnosed according to the current generally accepted standard in the clinic, and their CT images were analyzed. Results Among the 52 cases,the CT manifestations included nodule and the shadow of tumor in 27 cases, the shadow of cavitates in 11 ones,halo in 16 ones, air - crescent sign in 9 ones, the formation of aspergill0ma in 4 ones, miliary - like shadow in 2 ones, inordinance exudation and consolidation in 23 ones, pleural effusion in 4 ones, and lung hilus or the mediastinum lymphadenectasis in 5 ones. Conclusion The CT manifestations of pulmonary invasive infections with fungi after renal transplantation are diversified and lack specificity. When the focus of infection has the appearance of nodule, the shadow of tumor, and especially air - crescent sign and the corona draft, it highly indicates the existence of aspergillus infection. If the focus has the change like ground - glass - type interstitial pneumonia, the infection is hard to be distinguished from other pulmonary infections.
出处 《西南国防医药》 CAS 2013年第3期272-275,共4页 Medical Journal of National Defending Forces in Southwest China
关键词 肾移植 真菌感染 CT 诊断 renal transplantation fungus infection lung CT diagnosis
  • 相关文献

参考文献11

  • 1Sileri P,Pursell K J,Coady N T,et al. A Standardized protocol forthe treament of severe pneumonia in kidney transplant recipients[J]. Clin Transplant,2002,16:450 - 454. 被引量:1
  • 2闵志廉,何长民主编..器官移植并发症[M].上海:上海科技教育出版社,2002:467.
  • 3Schrooder R,Michelon T,Fagundes I,et al. Antigenemia for cytom -egalovirus in renal transplantation, choosing a cut off for the diagnosiscriteria in cytom egalovirus disease [ J ]. Transplant Proc,2005,37 :2781-2783. 被引量:1
  • 4宋志芳,俞康龙,单红卫,马钧.机械通气在肾移植术后间质性肺炎合并急性呼吸窘迫综合征抢救中的价值探讨[J].中国危重病急救医学,2003,15(6):358-361. 被引量:46
  • 5Wakayama M,Shibuya K,Ando T,et al. A Deep - seated mycosisin patients with solid organ transplantation - a study of autopsiedcases in the United States [ J]. Kansenshogaku Zasshi,2000,74?4):378 -386. 被引量:1
  • 6Heussel C P, Kauczor H U, Heussel G E, et al. Pneumonia infebrile neutropenic patients and in bone marrow and blood stem -cell transplant recipients use of high - resolution computedtomography [ J]. J Clin Oncol, 1999,17 :796 - 805. 被引量:1
  • 7Gulati M,Kaur R,Jhav,et al. High - resolution CT in renal transplantpatients with suspected pulmonary infections [J]. Acta Radiol,2000,41 :237 - 241. 被引量:1
  • 8王同明,程敬亮,张会霞.急性白血病化疗后继发肺部真菌感染的CT诊断[J].临床放射学杂志,2008,27(6):786-788. 被引量:20
  • 9Sato M, Okamoto M, Takagi Y, et al. Pulmonary cryptococcosiswith a solitary focal groud - glass opacity on high - resolutioncomptuted tomography [ J ]. Intern Med,2004,43 (2):117 -119. 被引量:1
  • 10Sonnet S,Buitrago - T6llez C H,Tamm M,et al. Direct detectionof angioinvasive pulmonary aspergillosis in immunosuppressedpatients : preliminary results with high - resolution 16 - MDCTangiography[ J]. Am J Roentgenol,2005,185 (3) :746 - 751. 被引量:1

二级参考文献21

  • 1宋志芳,景炳文.综合ICU各种感染菌群分析[J].中国危重病急救医学,1993,5(6):334-336. 被引量:15
  • 2黄晓军.血液病/恶性肿瘤患者侵袭性真菌感染的诊断标准与治疗原则(草案)[J].中华内科杂志,2005,44(7):554-556. 被引量:423
  • 3党明海,郭佑民.肺曲菌病的临床与影像学[J].实用放射学杂志,2006,22(12):1537-1540. 被引量:27
  • 4中华医学会呼吸系病学会.成人呼吸窘迫综合征诊断标准(修改草案)[J].中华结核和呼吸杂志,1989,12:368-369. 被引量:2
  • 5Domej W, Wirnsberger G H,Zitta S, et al. Tuberculosis of the small bowel with perforation and hematogenous spread in a renal transplant recipient [J]. Z Gastroenterol, 1993,31 : 401 - 404. 被引量:1
  • 6Vaz A J. Miliary tuberculosis and adult respiratory distress syndrome in a renal transplantation recipient[J]. Chest, 1979, 75:412. 被引量:1
  • 7Modig J, Hedstrand U, Wegenius G, et al. Adult respiratory distress syndrome after renal transplantation: a case report [J]. Acta Anaesthesiol Scand, 1986,30 : 487 - 489. 被引量:1
  • 8Suffredini A F, Tobin M J, Wajszczuk C P, et al. Acute respiratory failure due to pneumocystis carinii pneumonia: clinical, radiographic, and pathologic course [J]. Crit Care Med,1985,13:237 -243. 被引量:1
  • 9陈灏珠.实用内科学[M].11版.北京:人民卫生出版社,2003:5 被引量:67
  • 10Denning DW, Evans EG, Kibbler CC, et al. Guidelines for the investigation of invasive fungal infections in hematological malignancy and solid organ transplantation. British society for Medical Mycology [ J ]. Eur J Clin Microbiol Infect Dis, 1997,16 (6) :424-436. 被引量:1

共引文献66

同被引文献26

  • 1范连慧,刘龙,向军,杨宏伟,李昕,曹志强.187例肾移植受者死亡原因分析[J].中华器官移植杂志,2005,26(8):461-463. 被引量:33
  • 2Chang GC,Wu CL,Pan SH,et al. The diagnosis of pneumonia in renal transplant recipients using invasive and noninvasive proce- dures[J].Chest, 2004,125 : 541-547. 被引量:1
  • 3Kupeli E,Ulubay G,Colak T,et al. Pulmonary complications in re- nal recipients after transplantation[J]. Transplant Proc, 2011,43 (2) :551-553. 被引量:1
  • 4De Keyzer K,Van Laecke S,Peeters P,et al. Human cytomegalovirus and kidney transplantation:a clinician, supdate[J]. Am J Kidney Dis,2011,58(1) : 118-126. 被引量:1
  • 5Waiser J, Sehotsehel R, Budde K, et al. Reactivation of tuberculo- sis after conversion from azathioprine to mycophenolate mofetill6 years renal transplantation[J]. Am J Kidney Dis,2000,35(3):E12. 被引量:1
  • 6Matuck T,Brasil P,Alvarenga M,et al. Tuberculosis in renal trans- plants in Rio De Janeiro[J]. Transplant Proc,2004,36 (4):905- 906. 被引量:1
  • 7Hoyo I,Linares L,Cervera C,et al.Epidemiology of Pneumonia in Kidney Transplantation[J]. Transplantation Proceedings,2010,42 (8) :2938-2940. 被引量:1
  • 8Andrassy J,Zeier M, Andrassy K.Do we need screening for throm- bophilia prior to kidney transplantation. Nephrol Dial Transplant, 2004,19 Suppl 4:64-68. 被引量:1
  • 9Elkentaoui H,Robert G,Pasticier G,et al.Therapeutic management of de novo urological malignancy in renal transplant recipients: the experience of the French Department of Urology and Kidney Transplantation from Bordeaux[J]. Urology,2010,75(1 ):126-133. 被引量:1
  • 10Marcen R, Galeano C, Fernandez-Rodriguez A ,et al.Effects of the new immunosuppressive agents on the occurrence of malignancies after renal transplantation[J].Transplant Proc,2010,42(8):3055- 3057. 被引量:1

引证文献2

二级引证文献4

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部