肾移植术后肺部真菌感染的CT表现  

Value of spiral CT in diagnosis of pulmonary invasive infections with fungi after renal transplantation

作　　者：黄柱飞[1] 黄欣[2] 马盈[1] 商雪林[1] 莫春开[1] 门造[1] 胡赟[1] 

机构地区：[1]解放军303医院放射科,南宁530021 [2]成都军区总医院高诊室

出　　处：《西南国防医药》2013年第3期272-275,共4页Medical Journal of National Defending Forces in Southwest China

摘　　要：目的分析肾移植术后肺部侵袭性真菌感染的CT表现,以期对临床治疗方法的选择及调整提供帮助。方法回顾分析我院2008～2010年肾移植术后肺部侵袭性真菌感染52例,所有病例按照临床现行通用标准进行确诊,并分析其CT图像。结果 52例患者中,CT表现为结节、肿块影27例,空洞影11例,晕征(halo)16例,空气新月征(air-crescent sign)9例,曲菌球形成4例,粟粒样影2例,不规则渗出、实变影23例,胸腔积液4例,肺门或纵隔淋巴结肿大5例。结论肾移植术后肺部真菌感染CT表现多样,缺乏特异性。当病灶表现为结节、肿块影、尤其出现特征性的空气新月征及晕征时,高度提示曲霉菌感染存在的可能;若呈磨玻璃样等间质性肺炎的改变,则难以与肺部其他类型的感染鉴别。Objective To analyze the CT manifestations of pulmonary invasive infections with fungi after renal transplantation in order to provide certain help to the selection and the adjustment of clinical treatment. Methods A retrospective analysis was made in the clinical data of 52 patients with pulmonary invasive infections with fungi after renal transplantation from 2008 to 2010. All the cases were finally diagnosed according to the current generally accepted standard in the clinic, and their CT images were analyzed. Results Among the 52 cases,the CT manifestations included nodule and the shadow of tumor in 27 cases, the shadow of cavitates in 11 ones,halo in 16 ones, air - crescent sign in 9 ones, the formation of aspergill0ma in 4 ones, miliary - like shadow in 2 ones, inordinance exudation and consolidation in 23 ones, pleural effusion in 4 ones, and lung hilus or the mediastinum lymphadenectasis in 5 ones. Conclusion The CT manifestations of pulmonary invasive infections with fungi after renal transplantation are diversified and lack specificity. When the focus of infection has the appearance of nodule, the shadow of tumor, and especially air - crescent sign and the corona draft, it highly indicates the existence of aspergillus infection. If the focus has the change like ground - glass - type interstitial pneumonia, the infection is hard to be distinguished from other pulmonary infections.

关 键 词：肾移植 真菌感染 肺 CT 诊断 

分 类 号：R617[医药卫生—外科学]