Keywords:
Haematologic, Respiratory system, Thorax, CT, CT-Angiography, Education, Haematologic diseases
Authors:
A. Bruno, V. Cosi, M. milandri, G. Rasetto, R. Ioppolo, D. Capannelli, C. Sassi, G. Battista; Bologna/IT
DOI:
10.26044/ecr2019/C-2726
Methods and materials
We performed a single-center retrospective study at the Institute of Hematology “Lorenzo e Ariosto Seràgnoli”,
S.
Orsola-Malpighi Hospital,
University of Bologna,
Italy,
to evaluate the significance of the RHS in hematology patients.
The study design was approved by the institutional research committees in accordance with principles outlined in the Declaration of Helsinki.
Between January 2011 and September 2017,
we identified 23 hematology patients with possible/probable/proven IMD according to the EORTC/MSG criteria and the RHS on chest High Resolution Computed Tomography (HRCT) imaging (atoll group),
and a control group of 85 patients with possible/probable/proven IMD which did not present the RHS on HRCT imaging (control group).
All the HRCT were performed during febrile neutropenia post chemotherapy in patients at high risk for fungal infection according to the institutionally-validated risk score (Stanzani et al.
2013) and with clinical suspicion of IMD according to EORTC/MSG criteria and to the institutional guidelines.
Patients were submitted to a chest CT within 24-72 hours from the beginning of the empiric antibiotic therapy for the febrile episode,
followed by a clinical and radiological follow-up.
A pulmonary Computer Tomography Angiography (CTPA) was performed in 104/107 patients,
according to Stanzani et al.
CTPA images were analyzed for the presence of the vessel-occlusion sign (VOS) defined as an interruption of a vessel at the border of a focal lesion without depiction of the vessel inside the lesion or peripheral to the lesion.
We analyzed the correlation between the RHS and clinical factors reflecting the underlying immune status of patients (disease status,
neutropenia,
lymphocytopenia) using the Fisher exact probability test.