title: High-resolution computed tomographic findings of Aspergillus infection in lung transplant patients.
abstract: OBJECTIVE
  The aim of this study was to assess high-resolution computed tomographic (HRCT) findings at presentation in lung transplant patients diagnosed with pulmonary Aspergillus infection.
  
  
  METHODS
  We retrospectively reviewed HRCT findings from 23 patients diagnosed with pulmonary aspergillosis. Imaging studies were performed 2-5 days after the onset of symptoms. The patient sample comprised 12 men and 11 women aged 22-59 years (mean age, 43.6 years). All patients had dyspnea, tachypnea, and cough. Diagnoses were established with Platelia Aspergillus enzyme immunoassays for galactomannan antigen detection in bronchoalveolar lavage and recovery of symptoms, and HRCT findings after voriconazole treatment. The HRCT scans were reviewed independently by two observers who reached a consensus decision.
  
  
  RESULTS
  The main HRCT pattern, found in 65% (n=15) of patients, was centrilobular tree-in-bud nodules associated with bronchial thickening. This pattern was described in association with areas of consolidation and ground-glass opacities in 13% (n=3) of patients. Consolidation and ground-glass opacities were the main pattern in 22% (n=5) of patients. The pattern of large nodules with and without the halo sign was observed in 13% (n=3) of patients, and were associated with consolidation and ground-glass opacities in one case.
  
  
  CONCLUSIONS
  The predominant HRCT findings in lung transplant patients with pulmonary aspergillosis were bilateral bronchial wall thickening and centrilobular opacities with the tree-in-bud pattern. Ground-glass opacities and/or bilateral areas of consolidation were also common findings. Pulmonary nodules with the halo sign were found in only 13% of patients.
authors.affiliation: Hospital de Clínicas de Porto Alegre, Av. Cristovão Colombo 4105, ap.603-C, Post Code: 90560-005, Porto Alegre, RS, Brazil. Electronic address: gazzoni4@gmail.com.
authors.forename: Fernando Ferreira
authors.initials: FF
authors.lastname: Gazzoni
authors.affiliation: Santa Casa de Porto Alegre, Rua 24 de outubro 925/903, Post Code: 90510-002, Porto Alegre, RS, Brazil. Electronic address: brunohochhegger@gmail.com.
authors.forename: Bruno
authors.initials: B
authors.lastname: Hochhegger
authors.affiliation: Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2400, 2° andar, Post Code: 90035-003, Porto Alegre, RS, Brazil. Electronic address: severo@santacasa.tche.br.
authors.forename: Luiz Carlos
authors.initials: LC
authors.lastname: Severo
authors.affiliation: Federal University of Rio de Janeiro, Radiology Department, Av. Pedro Calmon, n° 550 - Cidade Universitária, Post Code: 21941-901, Rio de Janeiro, RJ, Brazil. Electronic address: edmarchiori@gmail.com.
authors.forename: Edson
authors.initials: E
authors.lastname: Marchiori
authors.affiliation: Santa Casa de Porto Alegre, Rua 24 de outubro 925/903, Post Code: 90510-002, Porto Alegre, RS, Brazil. Electronic address: acpasqualotto@hotmail.com.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Pasqualotto
authors.affiliation: Santa Casa de Porto Alegre, Rua 24 de outubro 925/903, Post Code: 90510-002, Porto Alegre, RS, Brazil. Electronic address: ana_sartori@hotmail.com.
authors.forename: Ana Paula Garcia
authors.initials: AP
authors.lastname: Sartori
authors.affiliation: Santa Casa de Porto Alegre, Rua 24 de outubro 925/903, Post Code: 90510-002, Porto Alegre, RS, Brazil. Electronic address: smschio@hotmail.com.
authors.forename: Sadi
authors.initials: S
authors.lastname: Schio
authors.affiliation: Santa Casa de Porto Alegre, Rua 24 de outubro 925/903, Post Code: 90510-002, Porto Alegre, RS, Brazil. Electronic address: jjcamargo@terra.com.br.
authors.forename: José
authors.initials: J
authors.lastname: Camargo
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging*; D016040:Lung Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D055732:Pulmonary Aspergillosis / Q000000981:diagnostic imaging* / Q000209:etiology*; D011856:Radiographic Image Enhancement / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*
keywords: Computed tomography; Lung transplantation; Pulmonary aspergillosis