艾滋病患者合并肺部机遇性感染性疾病CT影像学特征及诊断  

CT Imaging Features and Diagnosis of Pulmonary Opportunistic Infection in Patients with AIDS

作　　者：邹红群 李松 李全康 杨俊涛 

机构地区：[1]云南省大理州人民医院放射科CT室,云南大理671000

出　　处：《中国现代医生》2010年第2期78-80,共3页China Modern Doctor

摘　　要：目的探讨HIV/AIDS患者肺部机遇性感染CT表现特点。方法回顾性分析大理州人民医院感染科临床及病理检验证实的114例AIDS患者的肺部影像学表现。全部病例均有完整的X线胸片资料,其中45例同时行CT扫描,部分行HRCT扫描。结果AIDS合并肺孢子型肺炎(PCP)45例,典型表现为双侧肺周旁到中下肺野弥漫对称性分布的网格状影,部分融合成斑片状、结节状影或呈毛磨玻璃样改变。HIV合并肺结核15例,细菌性肺炎4例,其影像学表现与普通肺结核及肺炎表现类似。HIV合并肺真菌感染26例,表现为肺空洞内霉菌球形成,可见空气新月征。淋巴瘤2例,表现为肺内斑点、斑片状影,肺门纵隔淋巴结肿大。卡波济氏肉瘤1例,表现为肺内多发大小不等结节影。结论CT检查是AIDS基本的影像学检查方法,能更好地显示病变的部位、形态以及细微病变。双肺磨玻璃影、网状影、碎石路征为艾滋病伴肺孢子型肺炎(PCP)的特征性表现。Objective To investigate the CT imaging features of lung opportunistic infection in patients with AIDS. Methods A retrospective analysis was made of lung imaging features of 114 cases of AIDS confirmed by clinical and pathological examination from Department of Infection of Dali Area People＇s Hospital. All patients had complete information on X-ray,in which 45 cases had CT scanning with some of HRCT scanning. Results There were 45 cases of AIDS with pneumocystis carinii pneumonia （PCP） whose typical manifestations showed diffuse symmetrical grid shadow from bilateral pulmonary around to the middle -lower lung field,some of the shadow merging into patching-like and nodular shadow or showing a ground-glass -like change. The imaging manifestations showed pulmonary tuberculosis in 15 cases of HIV and bacterial pneumonia in 4 cases of HIV,similar to ordinary TB and pneumonia. The imaging manifestations showed pulmonary fungal infection in 26 cases of HIV,with fungus balls formed and air crescent sign seen in the lung cavity. Two cases of lymphoma showed the lungs spots and patchy shadow and hilar mediastinal lymph node enlargement and one case of Kaposi＇s sarcoma showed multiple pulmonary nodules of varying sizes. Conclusion CT scanning is a basic AIDS imaging examination,and can better display the lesion site,shape,and subtle lesions. The characteristic features of AIDS-acquired pneumonia associated with PCP are bilateral pulmonary ground-glass shadow,reticular shadow and gravel road sign.

关 键 词：艾滋病(获得性免疫缺陷综合征) 机遇性感染 肺孢子菌肺炎 螺旋CT扫描 

分 类 号：R512.91[医药卫生—内科学]