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CT Findings of Pneumonia After Lung Transplantation

¹ Department of Radiology, University of Wisconsin Hospital and Clinics, E3/311 Clinical Science Center, 600 Highland Ave., Madison, WI 53792-3252.
² Department of Radiology, University of British Columbia Hospital and Health Sciences Centre, Vancouver Hospital and Health Sciences Centre, Heather Pavilion, 855 W. 12th Ave., Vancouver, B.C., Canada V5Z1M9.
³ Department of Radiology, University of Michigan Medical Center, 1500 E. Medical Center Dr., Ann Arbor, MI 48109-0326.

OBJECTIVE. The purpose of this study was to describe the CT findings of pneumonia in patients who had undergone lung transplantation and to determine if specific imaging features existed for the different infectious organisms.

MATERIALS AND METHODS. The authors retrospectively reviewed the medical records of 262 patients with transplanted lungs at two lung transplantation centers. Patients with a documented pneumonia and correlating abnormal findings on CT (39 patients with 45 pneumonias) were included in the study.

RESULTS. Of 45 pneumonias, Cytomegalovirus (n = 15), Pseudomonas (n = 7), and Aspergillus (n = 8) organisms were the most common single responsible infectious agents. The most common CT findings of pneumonia consisted of consolidation (n = 37; 82%), ground-glass opacification (n = 34; 76%), septal thickening (n = 33; 73%), pleural effusion (n = 33; 73%), and multiple (n = 25; 56%) or single (n = 2; 4%) nodules. No significant difference in the prevalence of findings was revealed among bacterial, viral, and fungal pneumonias (p >.05, chisquare test). Of 25 pneumonias in patients with a single transplanted lung, parenchymal abnormalities involved both lungs in 12 (48%), only the transplanted lung in 11 (44%), and only the native lung in two (8%).

CONCLUSION. The manifestations revealed on CT of bacterial, viral, and fungal pneumonia after lung transplantation are similar, consisting of a combination of consolidation, ground-glass opacification, septal thickening, pleural effusion, or multiple nodules. Therefore, these findings cannot be used to suggest the infectious organisms in this patient population.

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