[Importance of digital thoracic radiography in the diagnosis of pulmonary infiltrates in patients with bone marrow transplantation during aplasia].
OBJECTIVE
Evaluation of digitized chest x-ray for the detection of pulmonary infiltrations in bone marrow transplant patients during aplasia.


METHODS
Digitized chest x-rays of 40 patients (21 female, 19 male) with "Fever of unknown origin" (FUO) were evaluated concerning radiological signs of pulmonary infiltrations and correlated to clinical findings, blood chemistry, microbiology and bronchoscopy. Additionally, an individual risk profile was established.


RESULTS
In 11/40 patients pulmonary infiltrations were detected in digitized chest x-rays (group 1). 10/11 developed an infectious pulmonary infiltration. 29/40 patients developed no pulmonary infiltration (group 2). When fever increased for the first time (initial chest x-ray) a sensitivity, specificity, positive and negative predictive value of 46%, 86%, 56%, 81% and for the chest x-rays in progress of 61%, 79% 68% and 73% was found. C-reactive protein and temperature increase occurred statistically significantly earlier (p < 0.05) in group 1 compared to group 2. The average latency of digital chest x-rays in comparison to c-reactive protein and temperature increase was 6 days. The incidence of risk factors was significantly higher in group 1 in comparison to group 2 (p < 0.05).


CONCLUSIONS
Digitized chest x-rays are not a reliable method for primary detection of pulmonary infiltrations after bone marrow transplantation. Individual risk factors have to be taken into consideration to indicate further diagnostic methods such as computed tomography at an earlier time.
Weber
C
C
Abteilung für Röntgendiagnostik, Radiologische Klinik, Universitäts-Krankenhaus Eppendorf, Hamburg.
Maas
R
R
Steiner
P
P
Kramer
J
J
Bumann
D
D
Zander
A R
AR
Bücheler
E
E
D000328:Adult; D000741:Anemia, Aplastic / Q000150:complications / Q000209:etiology*; D000890:Anti-Infective Agents / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis; D000935:Antifungal Agents / Q000627:therapeutic use; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D003937:Diagnosis, Differential; D005260:Female; D015725:Fluconazole / Q000627:therapeutic use; D006801:Humans; D008171:Lung Diseases / Q000000981:diagnostic imaging* / Q000209:etiology; D008172:Lung Diseases, Fungal / Q000000981:diagnostic imaging / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D015242:Ofloxacin / Q000627:therapeutic use; D011014:Pneumonia / Q000000981:diagnostic imaging / Q000517:prevention & control; D011446:Prospective Studies; D011856:Radiographic Image Enhancement; D013902:Radiography, Thoracic; D012189:Retrospective Studies; D012307:Risk Factors; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use
D000890:Anti-Infective Agents; D000935:Antifungal Agents; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D015725:Fluconazole; D015242:Ofloxacin
Wertigkeit der digitalen Thoraxaufnahme bei der Detektion von Lungeninfiltraten knochenmarktransplantierter Patienten in der Aplasie.