不同免疫状态下肺隐球菌病CT表现的比较研究  

CT Findings of Pulmonary Cryptococcosis in Immunocompetent and Immunocompromised Patients: A Comparison Study

作　　者：谢丽璇[1] 陈友三[2] 刘士远[3] 施裕新[4] 

机构地区：[1]广州军区武汉总医院核医学科PET-CT中心,武汉430070 [2]广州军区武汉总医院放射科 [3]第二军医大学附属长征医院影像科 [4]复旦大学附属上海市公共卫生临床中心放射科

出　　处：《临床放射学杂志》2014年第10期1510-1513,共4页Journal of Clinical Radiology

摘　　要：目的探讨不同免疫状态下肺隐球菌病的CT特征。方法回顾性分析经临床证实的72例肺隐球菌病的CT表现,并用Fisher确切概率法比较其在免疫抑制患者与免疫正常者、AIDS患者与非AIDS免疫抑制患者间的差异。结果最常见CT表现为单发或多发结节/肿块影65例(90.3%),其中伴空洞23例(35.4%),晕征24例(36.9%),支气管充气征17例(26.2%);其次为实变21例(29.2%);其他少见征象包括磨玻璃影(GGO)13例(18.1%),网格或线样影11例(15.3%),胸腔积液8例(11.1%),纵隔或肺门淋巴结肿大5例(6.9%)。47例(65.3%)病变分布于外周带。结节中空洞形成率在AIDS患者中显著高于非AIDS免疫抑制患者(P=0.002),在免疫抑制者中显著高于免疫正常者(P=0.009);支气管充气征的发生率在免疫正常者中显著高于免疫抑制者(P=0.005)。结论单发及多发结节/肿块影是肺隐球菌病最常见的CT表现,不同免疫状态患者结节/肿块内部结构存在差异。Objective To investigate CT characteristic features of pulmonary cryptococcosis in patients being in different immune status.Methods Based on the immune condition,the patients were divided into immunocompetent group,immunocompromised group,AIDS group and non-AIDS immunocompromised group.CT findings in 72 patients with clinically-proved pulmonary cryptococcosis were retrospectively analyzed.Using Fisher＇s exact test analysis the results were compared between each other among the four groups.Results The most common CT finding was pulmonary nodules /masses（n =65,90.3%）,either solitary or multiple.Other findings included halo sign（n =24）,cavitation（n =23） and air bronchogram（n=17）.Areas of consolidation（n=14）,areas of GGO（n=13）,linear opacities（n=11）,lymphadenopathy（n=5）,and pleural effusion（n=8） were uncommon.The parenchymal abnormalities located peripherally were seen in 65.3% of the cases（n=47）.Cavitations within nodules /masses were more frequently found in immunocompromised patients than in immunocompetent patients（P=0.009）,as well as more frequently in AIDS patients than in nonAIDS immunocompromised patients（P=0.002）.Air bronchograms within nodules /masses were more often seen in immunocompetent patients than in immunocompromised patients（P=0.005）.Conclusion Solitary or multiple pulmonary nodules /masses are the most common CT finding in pulmonary cryptococcosis.Significant difference in the internal structure of the nodules /masses exists between the patients being in different immune status.

关 键 词：肺 隐球菌 新型 体层摄影术 X线计算机 

分 类 号：R519.4[医药卫生—内科学]