石玉铸,李连波,李丽,王凯,刘博锋,陈曼.儿童异基因造血干细胞移植术后肺移植物抗宿主病CT表现[J].中国医学影像技术,2024,40(12):1851~1855
儿童异基因造血干细胞移植术后肺移植物抗宿主病CT表现
CT manifestations of pulmonary graft-versus-host disease after allogenichematopoietic stem cell transplantation in children
投稿时间:2024-05-13  修订日期:2024-10-15
DOI:10.13929/j.issn.1003-3289.2024.12.010
中文关键词:  儿童  造血干细胞移植    移植物抗宿主病  体层摄影术,X线计算机
英文关键词:child  hematopoietic stem cell transplantation  lung  graft vs host disease  tomography, X-ray computed
基金项目:2023年度河北省医学科学研究课题计划(20232043)。
作者单位E-mail
石玉铸 河北燕达陆道培医院放射科, 河北 廊坊 065201  
李连波 河北燕达陆道培医院放射科, 河北 廊坊 065201  
李丽 河北燕达陆道培医院放射科, 河北 廊坊 065201  
王凯 河北燕达陆道培医院放射科, 河北 廊坊 065201  
刘博锋 河北燕达陆道培医院放射科, 河北 廊坊 065201  
陈曼 河北燕达陆道培医院放射科, 河北 廊坊 065201 cmym20140716@163.com 
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中文摘要:
      目的 观察儿童异基因造血干细胞移植术(allo-HSCT)后肺移植物抗宿主病(GVHD)CT表现。方法 回顾性分析311例接受allo-HSCT后并发肺GVHD患儿,根据GVHD发病于allo-HSCT后100天内或其后分为急性组(n=82)与慢性组(n=229);对比组间胸部CT表现及治疗后生存状况。结果 儿童allo-HSCT后肺GVHD 主要CT表现包括磨玻璃密度(GGO,82/311,26.37%)、空气潴留(78/311,25.08%),以及支气管壁增厚(32/311,10.29%)、支气管扩张(28/311,9.00%)、胸腔积液(43/311,13.83%)、小叶间隔增厚(43/311,13.83%)、胸膜增厚(41/311,13.18%)及胸腔漏气综合征(41/311,13.18%)。急性组出现局灶性GGO及弥漫性GGO、胸腔积液及小叶间隔增厚占比均高于慢性组(P均<0.05),而空气潴留及支气管扩张占比均低于慢性组(P均<0.05);组间其余CT表现差异均无统计学意义(P均>0.05)。治疗后85例死亡,死亡率27.33%(85/311),在急性组(30/82,36.59%)高于慢性组(55/229,24.02%)(χ2=4.802,P=0.031)。结论 儿童allo-HSCT后肺GVHD CT表现具有一定特征性。
英文摘要:
      Objective To investigate CT manifestations of pulmonary graft-versus-host disease (GVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) in children. Methods A total of 311 children with pulmonary GVHD who underwent allo-HSCT were retrospectively analyzed. According to the onset time of pulmonary GVHD within 100 days after allo-HSCT or not, the patients were divided into acute group (n=82) and chronic group (n=229). Chest CT manifestations were observed and compared between groups, and children survival after treatments were recorded an d compared between groups. Results The main CT manifestations of pulmonary GVHD after allo-HSCT in children included ground glass opacity (GGO) (82/311, 26.37%), air trapping (78/311, 25.08%), thickening bronchial wall (32/311, 10.29%), bronchiectasis (28/311, 9.00%), pleural effusion (43/311, 13.83%), thickening interlobular septum (43/311, 13.83%), thickening pleura (41/311, 13.18%) and thoracic air leak syndrome (41/311, 13.18%). The proportion of localized GGO, diffuse GGO, pleural effusion and thickening interlobular septum in acute group were all higher, while of air trapping and bronchiectasis were both lower than those in chronic group (all P<0.05). No significant difference of other menifeatations was found between groups (all P>0.05). After treatments, 85 cases died, and the mortality rate was 27.33% (85/311), which in acute group (30/82, 36.59%) was higher than in chronic group (55/229, 24.02%) (χ2=4.802, P=0.031). Conclusion CT manifestations of pulmonary GVHD after allo-HSCT in children had certain characteristics.
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