CAJ | 학술논문

目的初步探讨血液病患者药物性肺损伤的MSCT表现.方法 11例确诊为药物性肺损伤的血液病患者均经MSCT平扫检查.11例中6例引起肺损伤的药物为抗肿瘤药,5例为非抗肿瘤药(免疫抑制剂2例、抗真菌药2例、抗肿瘤免疫调节剂1例).分析药物性肺损伤的MSCT表现.结果 11例患者均有胸部CT的异常,主要表现:磨玻璃状影8例次,实变影5例次,小叶间隔增厚3例次,局灶纤维化2例次.11例中病灶分布于外带6例、内带4例、无规律分布1例；病变位于下肺6例、上肺2例、无规律分布3例.1例合并两侧胸腔积液.3例胸部CT表现正常后再次给予相同药物,又出现同样的肺部损伤,且程度较前加重.结论下肺野外带出现磨玻璃密度影和实变影是药物性肺损伤最常见的CT征象.肺损伤可重复出现,且重复用药损伤加重.
목적 초보탐토혈액병환자약물성폐손상적MSCT표현.방법 11례학진위약물성폐손상적혈액병환자균경MSCT평소검사.11례중6례인기폐손상적약물위항종류약,5례위비항종류약(면역억제제2례、항진균약2례、항종류면역조절제1례).분석약물성폐손상적MSCT표현.결과 11례환자균유흉부CT적이상,주요표현:마파리상영8례차,실변영5례차,소협간격증후3례차,국조섬유화2례차.11례중병조분포우외대6례、내대4례、무규률분포1례；병변위우하폐6례、상폐2례、무규률분포3례.1례합병량측흉강적액.3례흉부CT표현정상후재차급여상동약물,우출현동양적폐부손상,차정도교전가중.결론 하폐야외대출현마파리밀도영화실변영시약물성폐손상최상견적CT정상.폐손상가중복출현,차중복용약손상가중.
Objective To investigate the spiral CT findings in hemopathic patients with druginduced pulmonary injury.Methods CT images obtained in 11patients with drug-induced pulmonary injury were retrospectively analyzed.Six patients had antineoplastic agent-induced pulmonary injury and 5 patients had non-neoplastic agent-induced pulmonary injury (immunosuppressor in 2 patients,antifungal in 2 patients,antineoplastic immunomodulators in 1 patient).CT findings were reviewed by a chest radiologist.Results All 11patients had parenchymal abnormalities on MSCT scans,including ground-glass opacities( n =8 ),consolidation( n =5 ),interlobular septal thickening( n =3 ) and focal fibrosis ( n =2 ).The abnormalities were bilateral and asymmetric in all patients.They were mainly in the peripheral lung regions in 6 patients,in the central lung regions in four,and irregularly located in one.The abnormalities involved mainly the lower lung zones in six patients,the upper lung zones in two,and all lung zones homogeneously in three.One patient had fluid in bilateral pleural cavities.Three patients were given the same agent once more after the imaging turned to normal,and they presented with same clinical symptoms and similar but more serious imaging findings.Conclusions Drug-induced pulmonary injury usually manifests as areas of ground-glass opacity and consolidation,which most commonly involves the peripheral lungs and lower lung zones.Drug-induced pulmonary injury shows reproducible but more serious lesions when the patient is given the same agent once more.