Schuhmacher Neto R, Giacomelli I L, Schuller Nin C, da Silva Moreira J, Comaru Pasqualotto A, Marchiori E, Loureiro Irion K, Hochhegger B
Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil; Department of Radiology and Pneumology, Santa Casa Hospital Complex in Porto Alegre, Prof. Annes Dias, 295, Porto Alegre, 90020-090, Brazil.
Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil; Department of Radiology and Pneumology, Santa Casa Hospital Complex in Porto Alegre, Prof. Annes Dias, 295, Porto Alegre, 90020-090, Brazil.
Clin Radiol. 2017 Oct;72(10):899.e9-899.e14. doi: 10.1016/j.crad.2017.05.006. Epub 2017 Jun 10.
To assess the high-resolution computed tomography (HRCT) findings in liver transplant patients diagnosed with pulmonary Mycobacterium tuberculosis infection.
The HRCT findings from 19 patients diagnosed with pulmonary tuberculosis infection after liver transplantation were reviewed. The patients included were 12 men and seven women, age range 23-65 years; mean age 57 years. The diagnosis was established with Mycobacterium tuberculosis detection in bronchoalveolar lavage, sputum, or biopsy. HRCT images were reviewed independently by two observers who reached a consensus decision. The HRCT findings were classified as (1) miliary nodules; (2) cavitation and centrilobular tree-in-bud nodules; (3) ground-glass attenuation and consolidation; and (4) mediastinal lymph node enlargement.
The time between the transplantation and the diagnosis of pulmonary tuberculosis ranged from 7 to 153 days with an average of 79 days. The main HRCT pattern was cavitation and centrilobular tree-in-bud nodules (79%) followed by mediastinal lymph node enlargement (10.4%), ground-glass attenuation or consolidation (5.2%) and miliary nodules (5.2%). None of the patients presented pleural effusion. The cavitation and centrilobular tree-in-bud nodules pattern had upper lobe predominance, and ground-glass attenuation and consolidation pattern had middle lobe/lingular segment predominance.
The main HRCT pattern of pulmonary tuberculosis in liver transplant patients was cavitation and centrilobular tree-in-bud nodules.
评估经高分辨率计算机断层扫描（HRCT）诊断为肝移植患者肺部结核分枝杆菌感染的情况。
回顾了19例肝移植后诊断为肺部结核感染患者的HRCT表现。纳入患者包括12名男性和7名女性，年龄范围为23 - 65岁；平均年龄57岁。通过支气管肺泡灌洗、痰液或活检中检测到结核分枝杆菌来确诊。由两名观察者独立回顾HRCT图像并达成共识。HRCT表现分为：（1）粟粒结节；（2）空洞形成及小叶中心性树芽征结节；（3）磨玻璃影及实变；（4）纵隔淋巴结肿大。
肝移植与肺结核诊断之间的时间间隔为7至153天，平均79天。主要的HRCT表现为空洞形成及小叶中心性树芽征结节（79%），其次是纵隔淋巴结肿大（10.4%）、磨玻璃影或实变（5.2%）以及粟粒结节（5.2%）。所有患者均未出现胸腔积液。空洞形成及小叶中心性树芽征结节型以上叶为主，磨玻璃影及实变型以中叶/舌段为主。
肝移植患者肺结核的主要HRCT表现为空洞形成及小叶中心性树芽征结节。
