Diagnostic Analysis of Computed Tomography Patterns in Patients With Invasive Pulmonary Aspergillosis After Solid-Organ Transplantation
| Autor: | Koray Hekimoglu, Mahir Kirnap, Irem Serifoglu, Mehmet Haberal, Murat Haberal |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Computed tomography Lung biopsy 030230 surgery Opportunistic Infections Aspergillosis 03 medical and health sciences Immunocompromised Host 0302 clinical medicine Predictive Value of Tests Multidetector Computed Tomography medicine Humans In patient Lung Retrospective Studies Invasive Pulmonary Aspergillosis Transplantation medicine.diagnostic_test business.industry Retrospective cohort study Organ Transplantation Invasive pulmonary aspergillosis medicine.disease Bronchoalveolar lavage Treatment Outcome Predictive value of tests Multiple Pulmonary Nodules Female Radiology business Immunosuppressive Agents |
| Zdroj: | Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation. 17(Suppl 1) |
| ISSN: | 2146-8427 |
| Popis: | Objectives The aim of this study was to assess initial and follow-up computed tomography findings of invasive pulmonary aspergillosis in solid-organ transplant recipients and to examine the most common computed tomography patterns during hospitalization. Materials and methods From January 2011 to September 2016, the total number of solid-organ transplant patients at our institution was 784. These patients consisted of 550 kidney, 164 liver, and 67 heart transplant recipients. Of these, 15 patients had a proven diagnosis of invasive pulmonary aspergillosis according to clinical and radiologic features with culture evidence of aspergillosis from bronchoalveolar lavage or lung biopsy. Computed tomography examinations were performed at initial diagnosis and at follow-up for evaluation of treatment. Computed tomography patterns were retrospectively evaluated by 2 experienced radiologists. Configurations and types of the largest lesions in each of the 15 patients were evaluated, and changes to lesions during treatment were recorded. Invasive pulmonary aspergillosis patterns were categorized into 6 main groups: ground-glass opacity, nodules, irregular nodules, patchy consolidation, cavity, and tree-in-bud patterns. Results The most common patterns were ground-glass opacity and irregular nodules, which were observed in 12 of 15 patients (80%), followed by regular nodules (73%), patchy consolidation and cavity (26%), and tree-in-bud pattern (20%). Long-term follow-up computed tomography studies showed that the regular nodules, tree-in-bud patterns, and groundglass opacity areas gradually reduced by 50% in 4 weeks. However, patchy consolidations and irregular nodules showed less regression than the other lesions over the 4-week period. Conclusions Irregular nodules and ground-glass opacity were the most common computed tomography patterns in our solid-organ transplant recipients. Computed tomography patterns without irregular nodules and patchy consolidations may be associated with better prognosis due to their relatively rapid healing. |
| Databáze: | OpenAIRE |
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