Pulmonary disease in liver transplant recipients. Spectrum of CT features.
OBJECTIVE
To determine the features of pulmonary disease in liver transplant recipients by CT.


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).


CONCLUSIONS
Thoracic CT of liver transplant recipients aids in detecting and classifying both infectious and neoplastic complications.
Knollmann
F D
FD
Department of Radiology, Virchow-Clinic, Medical Faculty, Humboldt-University, Berlin, Germany.
Mäurer
J
J
Bechstein
W O
WO
Vogl
T J
TJ
Neuhaus
P
P
Felix
R
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001228:Aspergillosis / Q000000981:diagnostic imaging; D001995:Bronchography; D016009:Chi-Square Distribution; D003586:Cytomegalovirus Infections / Q000000981:diagnostic imaging; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007876:Legionellosis / Q000000981:diagnostic imaging; D008113:Liver Neoplasms / Q000000981:diagnostic imaging; D016031:Liver Transplantation / Q000009:adverse effects / Q000000981:diagnostic imaging*; D008171:Lung Diseases / Q000097:blood / Q000000981:diagnostic imaging* / Q000209:etiology; D008172:Lung Diseases, Fungal / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging; D010996:Pleural Effusion / Q000000981:diagnostic imaging; D018410:Pneumonia, Bacterial / Q000000981:diagnostic imaging; D011020:Pneumonia, Pneumocystis / Q000000981:diagnostic imaging; D011024:Pneumonia, Viral / Q000000981:diagnostic imaging; D001261:Pulmonary Atelectasis / Q000000981:diagnostic imaging; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed