Merlini Laura, Borzani Irene Maria Olivia, Anooshiravani Mehrak, Rochat Isabelle, Ozsahin Ayse Hulya, Hanquinet Sylviane
Paediatric Radiology Unit, University of Geneva Children's Hospital, Geneva 1205, Switzerland.
Pediatr Radiol. 2008 Nov;38(11):1201-9. doi: 10.1007/s00247-008-0984-9. Epub 2008 Sep 4.
Late-onset noninfectious pulmonary complications (LONIPCs) are life-threatening complications of bone marrow transplantation (BMT). Several pathological patterns are described in the literature with different prognoses, and with different relationships to graft-versus-host disease (GVHD). The role of high-resolution CT (HRCT) is not yet well established.
To illustrate different patterns of LONIPCs on HRCT in allogeneic versus autologous BMT in order to investigate the correlation with chronic GVHD (cGVHD).
A total of 67 HRCT scans were performed in 24 patients with noninfectious pulmonary disease at least 3 months after BMT (16 allogeneic, 8 autologous). Abnormality patterns and extension on HRCT images were correlated with the clinical outcome and with the severity of cGVHD.
Of 24 patients, 9 showed LONIPCs (1 autologous, 8 allogeneic). There was a significant association between abnormalities on HRCT and severe cGVHD (P = 0.038), with no specific pattern. Prognosis seemed to be related to the severity of cGVHD and not to the extent of abnormalities on HRCT.
The significant association between abnormalities on HRCT and severe GVHD suggests that LONIPCs can be a pulmonary manifestation of the disease. HRCT is a useful tool when combined with clinical data.
迟发性非感染性肺部并发症（LONIPC）是骨髓移植（BMT）的危及生命的并发症。文献中描述了几种具有不同预后且与移植物抗宿主病（GVHD）有不同关系的病理模式。高分辨率CT（HRCT）的作用尚未完全明确。
阐述异基因与自体BMT中LONIPC在HRCT上的不同模式，以研究其与慢性GVHD（cGVHD）的相关性。
对24例BMT后至少3个月患有非感染性肺部疾病的患者进行了67次HRCT扫描（16例异基因，8例自体）。HRCT图像上的异常模式和范围与临床结果及cGVHD的严重程度相关。
24例患者中，9例出现LONIPC（1例自体，8例异基因）。HRCT异常与严重cGVHD之间存在显著关联（P = 0.038），且无特定模式。预后似乎与cGVHD的严重程度有关，而非与HRCT上的异常范围有关。
HRCT异常与严重GVHD之间的显著关联表明LONIPC可能是该疾病的肺部表现。HRCT与临床数据相结合时是一种有用的工具。
