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肺移植术后排斥反应的影像学检查方法现状及展望

徐琳 严浩吉 王俊杰 唐宏涛 李偲涵 陈婷婷 张涵 付思怡 田东

徐琳, 严浩吉, 王俊杰, 等. 肺移植术后排斥反应的影像学检查方法现状及展望[J]. 器官移植, 2021, 12(5): 544-549. doi: 10.3969/j.issn.1674-7445.2021.05.007
引用本文: 徐琳, 严浩吉, 王俊杰, 等. 肺移植术后排斥反应的影像学检查方法现状及展望[J]. 器官移植, 2021, 12(5): 544-549. doi: 10.3969/j.issn.1674-7445.2021.05.007
Xu Lin, Yan Haoji, Wang Junjie, et al. Current status and prospect of imaging examination methods for rejection after lung transplantation[J]. ORGAN TRANSPLANTATION, 2021, 12(5): 544-549. doi: 10.3969/j.issn.1674-7445.2021.05.007
Citation: Xu Lin, Yan Haoji, Wang Junjie, et al. Current status and prospect of imaging examination methods for rejection after lung transplantation[J]. ORGAN TRANSPLANTATION, 2021, 12(5): 544-549. doi: 10.3969/j.issn.1674-7445.2021.05.007

肺移植术后排斥反应的影像学检查方法现状及展望

doi: 10.3969/j.issn.1674-7445.2021.05.007
基金项目: 

医学影像四川省重点实验室开放课题 MIKLSP202007

南充市市校合作科研专项 19SXHZ0189

川北医学院附属医院科研发展计划项目 2021ZK003

详细信息
    通讯作者:

    田东,男,博士,副主任医师,研究方向为肺移植基础与临床研究,E-mail: TianD_EATTS@nsmc.edu.cn

  • 中图分类号: R617, R445

Current status and prospect of imaging examination methods for rejection after lung transplantation

More Information
  • 摘要: 肺移植是治疗终末期肺病的唯一有效手段,其术后发生的排斥反应是影响受者预后的主要因素。影像学检查可作为无创手段,辅助其他检查监测肺移植术后排斥反应。目前已报道的影像学方式较多,明确各种影像学检查的优势与不足,有助于排斥反应的早期诊断,使得肺移植受者可以得到及时治疗,进而提高其生活质量及预后。本文对肺移植术后排斥反应各种影像学检查的利弊及进展进行综述,为寻找肺移植术后排斥反应的最佳无创检查手段提供参考,提高受者远期生存。

     

  • 表  1  肺移植术后排斥反应影像学检查方法

    Table  1.   Imaging methods of rejection after lung transplantation

    影像学方法 影像学表现 优点 缺点
    AR CLAD
    胸部X线检查 肺间质纤细的网格影、肺段实变和肺门周围实变影 早期:表现正常
    加重:肺血管纹理减少,亚段肺不张
    晚期:不规则及不透明区域增加
    操作简单、成本较低 诊断效果不佳
    CT检查 肺部磨玻璃影及小叶间隔增厚 BOS:肺体积和肺密度的纵向变化明显,伴有细支气管空气潴留支气管扩张
    RAS:肺间质毛玻璃结节、蜂窝状改变和小叶间隔增厚
    密度分辨率较高、显示人体解剖结构能力强 辐射较大、准确性仍存在争议
    MRI检查 超短回波时间MRI序列可显示AR引起的变化 肺通气动力学参数及区域异质性 高分辨率、高清晰度、可多参数成像与多方位扫描 价格昂贵
    PET/CT检查 18F-FDG摄取量增加 BOS:18F-FDG摄取量增加,纤维增生活跃、肺胸膜实质改变
    RAS:18F-FDG摄取量降低
    唯一用解剖形态方式进行功能、代谢和受体显像的技术 无法精确定位病灶
    超声检查 存在B线 BOS:胸膜下实变伴有B线
    RAS:肺间质性纤维化
    无辐射、易用性、实时性、便携性、低成本 肺部气体干扰及肋骨遮挡,超声检查受限
    注:①18F-FDG为18F-氟代脱氧葡萄糖。
    下载: 导出CSV
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  • 收稿日期:  2021-06-30
  • 网络出版日期:  2021-09-15
  • 刊出日期:  2021-09-15

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