免疫正常人群原发性肺隐球菌病CT特征分析  

CT Diagnosis of Primary Pulmonary Cryptococcosis in Immunocompetent Patients

作　　者：刘国兵[1] 屈艳娟[1] 田志雄[1] 杨桂芳[2] 曹毅媛[1] 罗锐[1] 

机构地区：[1]武汉大学中南医院放射科,430071 [2]武汉大学中南医院病理科,430071

出　　处：《临床放射学杂志》2013年第9期1267-1271,共5页Journal of Clinical Radiology

摘　　要：目的研究免疫正常人群肺原发性隐球菌病的影像学表现。方法回顾性分析经组织病理学确诊的26例原发性肺隐球菌病的临床表现和CT征象。结果 26例中19例有临床表现,以咳嗽最多,共14例。CT最常见征象为结节,共21例,其中8例单发,9例簇状多发,4例散在多发;13例结节形态不规则,19例边界不清楚;21例结节阳性病例中14例有结节周围晕征。病灶多发生于双肺下叶(15例),并多分布于外带(18例)。磨玻璃样影多见于老年人群,占66.7%。结论免疫正常人群原发性肺隐球菌病胸部CT典型的表现为双肺下叶外带簇状多发结节灶并结节周围晕征。而在老年人群中发现磨玻璃样影,无论伴或不伴结节,均需高度考虑隐球菌病可能。Objective To evaluate radiological manifestations of pulmonary cryptococcosis in immunocompetent patients. Methods Clinical, pathological, and CT features of 26 cases with histopathologically confirmed pulmonary cryptococcosis were analyzed retrospectively. Necessary statistical tests for differences between clinical and CT characteristics were performed. Results 19 cases had cough as the most common symptom （n = 14, 53.8% ）. Nodules （n = 21, 80. 8% ） were the most common CT findings. 8 cases presented with solitary and 9 with multiple nodules, while 13 cases presented with irregular and 19 with ill defined nodules. The halo sign was demonstrated, encompassing nodules in 14 of the 21 patients. Lesions were mainly localized in the lower lobes of the lungs （ n = 15,57.7% ） with peripheral distribution （ n = 18, 69.2% ）. Ground glass opacities were more easily detected in older patients （66.7%）. Conclusion Primary pulmonary cryptococcosis in immunocompetent patients exhibits certain CT characteristics. The typical presentation includes multiple nodules with the halo sign scattered in the peripheral field in the lower lobes of the bilateral lungs. However, attention should be taken when ground glass opacities is found with or without nodules in older patients.

关 键 词：肺隐球菌病 体层摄影术 X线计算机 晕征 

分 类 号：R519[医药卫生—内科学]