Abstract：
OBJECTIVES:To analyse the predominant radiological pattern of pulmonary lesions in adult hematologic patients at risk for invasive aspergillosis (IA) together with the results of serial serum Aspergillus galactomannan antigen testing (GM). MATERIAL AND METHODS:In a prospective study for patients at high risk of aspergillus pulmonary infection, serum GM were performed 2-3 times per week during the periods of high risk for IA and high-resolution CT (HRCT) was performed in case of abnormal chest X-ray (CXR) and/or persistent fever after 5 days of antibiotic treatment. Changes on HRCT scan were classified as airway IA and angioinvasive IA. IA was classified as proven or probable in accordance with the definitions stated by the European Organization for Research and Treatment of Cancer/Mycosis Study Group (EORTC-MS). Positive GM testing was not considered as microbiological criterion. RESULTS:38 hematological patients were diagnosed of probable (n=28) or proven (n=10) IA. 55% patients had a neutrophil count less than 500 mm(-3) (n=21), and 37% patients > or =2 risk factors for IA. All probable IA were diagnosed by bronchoalveolar lavage (BAL). Proven IA was reached by positive histopathologic and culture results of samples obtained by autopsy (n=4), percutaneous (n=3) or transbronchial biopsy (n=3). 18 patients had airway IA, and 60% had a GM level > or =1.5. 20 patients were diagnosed of angioinvasive IA from which 80% had a GM level > or =1.5. CONCLUSION:Serum GM levels may be lower in patients with airway IA than in those with an angioinvasive form. HRCT and serum GM are complementary tests in the diagnosis of IA.
journal_name
Eur J Radioljournal_title
European journal of radiologyauthors
Hidalgo A,Parody R,Martino R,Sánchez F,Franquet T,Giménez A,Blancas Cdoi
10.1016/j.ejrad.2008.03.026subject
Has Abstractpub_date
2009-07-01 00:00:00pages
55-60issue
1eissn
0720-048Xissn
1872-7727pii
S0720-048X(08)00192-7journal_volume
71pub_type
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journal_title：European journal of radiology
pub_type： 临床试验,杂志文章,随机对照试验
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pub_type： 杂志文章,meta分析
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pub_type： 杂志文章
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journal_title：European journal of radiology
pub_type： 杂志文章,评审
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