Halvorsen R A, DuCret R P, Kuni C C, Olivari M T, Tylen U, Hertz M I
Department of Radiology, School of Medicine, University of Minnesota, Minneapolis.
Clin Nucl Med. 1991 Apr;16(4):256-8. doi: 10.1097/00003072-199104000-00011.
A serious and often fatal complication of heart-lung transplantation is the development of obliterative bronchiolitis (OB). Currently the screening for OB is based on symptoms, pulmonary function tests, and transbronchial biopsies. The chest radiographs are often normal with OB. Obliterative bronchiolitis produces luminal narrowing of both bronchioles and bronchi resulting in areas of peripheral consolidation and occasional bronchiectasis. We report a patient in whom a chest film was normal, an aerosol ventilation lung scan was abnormal while a perfusion study was mildly abnormal. Simultaneously, routine CT was essentially normal while high resolution CT with 1 mm thick sections was clearly abnormal and demonstrated areas of consolidation. These imaging modalities detected clear-cut abnormalities at a time when the patient was symptomatic but prior to the development of demonstrable abnormality on chest radiograph.
心肺移植的一种严重且常致命的并发症是闭塞性细支气管炎（OB）的发生。目前，对OB的筛查基于症状、肺功能测试和经支气管活检。OB患者的胸部X光片通常正常。闭塞性细支气管炎会导致细支气管和支气管管腔狭窄，从而引起外周实变区域和偶发性支气管扩张。我们报告了一名患者，其胸部X光片正常，雾化通气肺扫描异常，而灌注研究轻度异常。同时，常规CT基本正常，而层厚1毫米的高分辨率CT明显异常并显示有实变区域。在患者出现症状时，但在胸部X光片出现可证实的异常之前，这些成像方式就检测到了明确的异常。
