艾滋病合并卡氏肺孢子虫肺炎的MSCT诊断  

MSCT Diagnosis of AIDS Accompanied By Pneumocystis Carinii Pneumonia

作　　者：廖茂超[1] 

机构地区：[1]贵阳市第一人民医院放射科,贵州550002

出　　处：《临床放射学杂志》2013年第1期69-71,共3页Journal of Clinical Radiology

摘　　要：目的认识艾滋病合并卡氏肺孢子虫肺炎的MSCT表现,以提高对该病影像学诊断准确率。方法回顾性分析2009至2012年间在本院经活检或纤维支气管镜刷检证实的14例艾滋病合并卡氏肺孢子虫肺炎患者的MSCT胸部检查资料。其中男9例,女5例,中位年龄53岁,均行16排螺旋CT常规检查,对其图像分别使用肺窗和纵隔窗显示进行观察。结果 14例中,两肺弥漫磨玻璃密度影9例,其中2例双肺粟粒状密度增高影伴双下肺索条状密度影,纵隔淋巴结增大5例,胸膜增厚8例,同时腹部CT检查腹膜后淋巴结肿大及双肾淋巴瘤1例;双下肺可见斑片状、索条状阴影1例;两肺表现为散在多发线状及网状影3例,并伴淋巴结增大1例;双上肺可见斑片状、索条状影1例。X线表现为肺纹理增粗,有多发线状及网状影,双肺门影增浓,肺尖部较清晰或病灶相对较轻。结论艾滋病患者胸部MSCT表现为双肺弥漫性渗出性病变呈斑点状、索条状、片状或网状,有明显的融合成片趋势,早期病变主要在肺门周围,随着病情的进展,病灶向周围肺野辐射状扩展,而肺尖部较清晰或病灶相对较轻应考虑合并卡氏肺孢子虫肺炎的诊断。Objective To discuss MSCT findings of AIDS with pneumocystis carinii pneumonia （PCP） in order to im prove its diagnostic accuracy. Methods MSCT data of 14 patients（9 males and 5 females,mean age 53 years） of AIDS with pneumoeystis carinii pneumonia （PCP） proved by biopsy or bronchoscopy brushing biopsy between 2009 to 2012 were analyzed retrospectively, images from the lung window and mediastinal window were observed. Results 14 cases, Lungs diffuse ground glass density in 9 cases：2 cases of bilateral pulmonary miliary nodules with both lung cable strip density shadow,5 cases of mediastinal lymphnode enlargement, pleural thickening in 8 cases, at the same time, the performance of abdominal CT included retroperitoneal lymphnodes and kidneys lymphoma in 1 case. Both lung patchy, cable strip shadow visible in 1 case, multiple linear and reticular image in 3 cases, and lymphnode increased in 1 case. Lung upper lobe visible patchy, cable strip shadow in 1 case. X ray showed lung markings thickening, multiple linear and mesh image,lungs hi lum enlargement,the apex of a clear or relatively mild lesions. Conclusion Typical CT performance of AIDS with pneu mocystis carinii pneumonia include the diffuse lung exudative lesions, obvious trend of mergence, early lesions mainly in the perihilar,radial expansion of the lesion to the surrounding lung field as the disease aggression, apex of a clear or rela tively mild lesions.

关 键 词：艾滋病 卡氏肺孢子虫肺炎 体层摄影术 X线计算机 

分 类 号：R563.1[医药卫生—呼吸系统]