肺毛霉菌病的CT及正电子发射计算机体层成像-CT表现  

CT and positron emission tomography-CT imaging features of pulmonary mucormycosis

作　　者：许尚文[1] 陈自谦[1] 钟群[1] 钱根年[1] 刘庆宏[2] 张盼[1] 赵春雷[1] 

机构地区：[1]第二军医大学福州临床医学院南京军区福州总医院医学影像科,350025 [2]第二军医大学福州临床医学院南京军区福州总医院病理科,350025

出　　处：《中华放射学杂志》2014年第7期551-554,共4页Chinese Journal of Radiology

摘　　要：目的 探讨肺毛霉菌病的CT及PET-CT表现,提高其诊断的准确率.方法 回顾性分析14例经手术或穿刺病理证实的肺毛霉菌病的胸部CT及PET-CT表现.所有患者均行MSCT平扫,10例行多期增强扫描检查,其中3例同时行氟代脱氧葡萄糖（18F-FDG） PET-CT检查.结果 13例患者肺内见多发斑片影,伴厚壁空洞9例（26个）、肺动脉栓塞4例;仅1例表现为肺内孤立性不规则肿块.病变侵犯临近支气管3例、胸腔少量积液4例,肺门及纵隔均未见明显肿大淋巴结影.增强扫描病灶实性部分增强较明显,平均增加（25±8） HU.PET-CT表现：1例病灶呈斑片状异常放射性浓聚,2例呈不规则环形的异常放射性浓聚,最大标准化摄取值（SUVmax）分别为6.2、4.6和3.6.结论 肺毛霉菌病的影像表现呈多样性,缺乏特征性表现.影像表现为多发厚壁空洞,合并肺动脉栓塞或侵犯支气管时应考虑到本病可能.Objective To improve the diagnostic accuracy of pulmonary mucormycosis（PM） by investigating imaging appearances of PM,including CT and PET-CT.Methods A retrospective analysis of unenhanced MSCT（n=14）,dynamic enhanced MSCT（n=10） and 18F-FDG PET-CT（n=3） examinations was conducted in 14 patients with surgically and pathologically proven PM.Results CT findings：13 patients had multiple patchy consolidation.Nine had thick-walled cavitiess（n=26） and 4 had pulmonary embolism,1 had solitary irregular masses,3 had adjacent bronchus invasion,4 had pleural effusion,14 had no mediastinal adenopathy.All the patients after renal transplantation had varied ground-glass opacifications and interlobular septal thickenings.The solid portion of lesions had strong enhancement with CT attenduation of （25±8） HU.PET-CT findings：3 cases were found with homogeneously or inhomogeneously increased 18F-FDG uptake（SUVmax 6.2,4.6,3.6）.Conclusions PM presents with widespread but lacked specific imaging features.A suggestive diagnosis could be made in some patients with imaging appearances of multiple thick-walled cavities,rapid changes,and complicated with pulmonary embolism or invaded bronchus and ＂sleevelet＂ sign.

关 键 词：毛霉菌病 肺 体层摄影术 X线计算机 正电子发射断层显像术 

分 类 号：R519[医药卫生—内科学]