TYPICAL RADIOLOGICAL FINDINGS AND COURSE OF INVASIVE PULMONARY ASPERGILLOSIS IN IMMUNE-SUPPRESSED PATIENTS

Typical radiological findings and course of invasive pulmonary aspergi llosis in immune-suppressed patients. Purpose: This retrospective stud y was designed to show whether invasive pulmonary aspergillosis, which is often difficult to diagnose by bronchoscopy or serology, can be di agnosed at an early stage by typical radiological findings on conventi onal radiographs or by CT, specially high resolution CT (HR-CT). Patie nts and Methods: In 19 Patients with 20 disease episodes, 20 thorax ra diographs and eight spiral CI examinations were performed and in four cases Tip-CT was also available. The earliest pathological findings an d the course of the disease were analysed and the results of the vario us examinations were compared. Results: 90% of chest examinations, inc luding CT and Tip-CT, showed the following lesions as part of the earl iest changes: round or wedge-shaped opacities or the so-called ''halo' ' sign. CT or Tip-CT always demonstrated more lesions than plain chest radiographs: 75% of lesions appeared typical and thereby contributed to the diagnosis. Conclusion: The typical radiological findings of rou nd or wedge-shaped opacities and the so-called ''halo'' sign are addit ional criteria for the diagnosis of invasive pulmonary aspergillosis. The superiority of CT or Tip-CT in the demonstration of pathological c hanges suggests that these should be used early in the investigation o f patients who are specially at risk.