侵袭性肺曲菌病CT诊断(附17例报告)  

CT Diagnosis of Invasive Pulmonary Aspergillosis (a Report of 17 Cases)

作　　者：邱乾德[1] 郑祥武[2] 滕陈迪[3] 相世峰[1] 黄晓辉[1] 

机构地区：[1]温州市第三人民医院影像科,浙江325000 [2]温州医学院附属第一医院放射科,浙江325000 [3]温州市第二人民医院放射科,浙江

出　　处：《放射学实践》2008年第9期1004-1006,共3页Radiologic Practice

摘　　要：目的:探讨侵袭性肺曲菌病(IPA)的CT表现。方法:回顾性分析经手术、病理证实的17例侵袭性肺曲菌病CT表现。结果:17例中患糖尿病3例,白血病3例,淋巴瘤2例,骨髓瘤2例,肺结核2例,肺癌术后1例,肾移植后1例,红斑狼疮长期服用激素1例,类风湿性关节炎长期服用激素1例,未患其它疾病者1例。17例中病变近胸膜下呈楔形大片状实变阴影6例,其中3例两肺伴多发结节样阴影;病变呈团块状阴影6例,团块边缘较光整,其中3例团块影内见大小不等小空洞,2例团块有轻微分叶,1例团块边缘略有"晕征";病变呈多发小结节病灶和多发小斑片状影散在分布两肺3例,小结节病灶边缘有"晕征";多发小斑片状影散在分布两肺2例,密度低,边缘模糊,呈磨玻璃样表现。结论:侵袭性肺曲菌病CT征象主要为楔形实变、团块状影、多发结节影及小斑片状影,多发结节伴"晕征"时应提示侵袭性肺曲菌病可能。Objective：To study the CT finding of invasive pulmonary aspergillosis.Methods：CT finding of surgery and pathology proved invasive pulmonary aspergillosis in 17 cases were retrospectively analysed.Results：Of the 17 patients with invasive pulmonary aspergillosis,the primary diseases included diabetes and leukemia for 3 patients each;lymphoma,myeloma and tuberculosis for 2 patients each;post-surgical lung cancer,kidney transplantation,lupus erythematosus with long term steroid therapy,rheumatoid arthritis with long term steroid therapy for 1 patient each;1 patient had no sickness before.The CT finding included large area of wedge-shaped sub-pleural pulmonary consolidation in 6 cases and 3 of which with concurrent bilateral multiple nodules;well-defined mass lesion in 6 cases and 3 of which showed intra-lesional small cavities with various size,2 of which showed slight lobulation,1 showed peripheral ＂halo sign＂;bilateral multiple pulmonary small nodules with peripheral ＂halo sign＂ as well as patchy opacities in 3 cases;bilateral small ill-defined low attenuated ground-glass-like opacities in 2 cases.Conclusion：The diagnosis of invasive pulmonary aspergillosis should be highly considered,when CT findings showing pulmonary large sub-pleural wedge-shaped consolidation,mass lesion,multiple nodular and patchy opacities and multiple nodules with ＂halo sign＂.

关 键 词：肺疾病 曲菌病 体层摄影术 X线计算机 

分 类 号：R519[医药卫生—内科学] R816.4[医药卫生—临床医学]