Ooi G C, Peh W C, Ip M
Department of Diagnostic Radiology, University of Hong Kong, Queen Mary Hospital, Hong Kong.
Respiration. 1998;65(3):187-91. doi: 10.1159/000029257.
High-resolution computed tomography (HRCT) has been described to be useful in assessing bronchiolitis obliterans (BO) syndrome in the transplanted lung. Currently, BO syndrome is diagnosed if lung function deterioration shows persistent or progressive irreversible airflow obstruction, with FEV1 of less than 80% of baseline values, without clinical evidence of infection. The aim of this study is to assess the value of HRCT in evaluating BO syndrome after allogenic bone marrow transplantation (BMT). Fourteen HRCT scans were performed in 6 women and 3 men with moderately severe irreversible airflow obstruction and a clinical diagnosis of BO syndrome after BMT. Two patients had normal HRCT scans. In the remaining 7 patients, 7 of 11 HRCT scans were abnormal, with non-specific findings of bronchial dilatation (1), consolidation (2), hypoattenuated areas (4) and vascular attenuation (4). In comparison with the consistency of positive HRCT findings of BO syndrome in transplanted lungs, HRCT surveillance for BO syndrome in post-BMT patients with clinically established disease is of limited value, unless other pulmonary complications such as opportunistic infections are to be excluded.
高分辨率计算机断层扫描（HRCT）已被描述为在评估移植肺中的闭塞性细支气管炎（BO）综合征方面有用。目前，如果肺功能恶化表现为持续性或进行性不可逆气流阻塞，且第一秒用力呼气容积（FEV1）低于基线值的80%，且无感染的临床证据，则可诊断为BO综合征。本研究的目的是评估HRCT在评估异基因骨髓移植（BMT）后BO综合征中的价值。对6名女性和3名男性进行了14次HRCT扫描，这些患者有中度严重不可逆气流阻塞且临床诊断为BMT后BO综合征。2例患者HRCT扫描正常。在其余7例患者中，11次HRCT扫描中有7次异常，表现为支气管扩张（1例）、实变（2例）、低密度区（4例）和血管变细（4例）等非特异性表现。与移植肺中BO综合征HRCT阳性结果的一致性相比，对临床已确诊疾病的BMT后患者进行HRCT监测BO综合征的价值有限，除非排除其他肺部并发症，如机会性感染。
