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Pulmonary disease in liver transplant recipients. Spectrum of CT features
F D Knollmann1, J Mäurer, W O Bechstein
1Department of Radiology, Virchow-Clinic, Medical Faculty, Humboldt-University, Berlin, Germany.
Purpose:
To determine the features of pulmonary disease in liver transplant recipients by CT.
Material And Methods:
Of 792 patients, 102 were referred to thoracic CT 3-2093 days after the transplantation procedure (median 107 days). All CT studies were retrospectively analyzed and correlated with clinical, microbiological, serological and histopathological findings.
Results:
Eighty-eight of 102 patients (86%) had an abnormal CT. In 25 patients (25%), an elevated right hemidiaphragm, basal atelectasis and small effusions were the only abnormalities. Fourty-one patients (40%) displayed an infiltrate and 13 (13%) a mass lesion. Evidence of cytomegalovirus (CMV) infection was found in 20 patients. CMV pneumonia was suggested by an interstitial pattern of pneumonia on CT (n=13). Pneumocystis carinii pneumonia was highlighted by peribronchovascular infiltrates (n=5/8), bacterial pneumonia (n=24) including legionellosis (n= 13) by bilateral effusions (n=14) and lobar consolidation (n= 13). In 7/41 patients (17%) with both clinically apparent pulmonary disease and CT signs of pneumonia, no pathogen could be detected. Neoplastic disease was mostly due to tumor recurrence (n=6).
Conclusion:
Thoracic CT of liver transplant recipients aids in detecting and classifying both infectious and neoplastic complications.