39例非免疫缺陷病毒患者肺隐球菌病的CT表现  

Computed tomography manifestations of pulmonary cryptococcosis in non-AIDS patients:analysis of 39 cases

作　　者：吴杰[1,2] 单飞[3] 邱建国[4] 施裕新[3] 王青乐[5] 张志勇[3,5] 

机构地区：[1]金坛市人民医院放射科,江苏213200 [2]常州市金坛区中医院 [3]上海市公共卫生临床中心影像科 [4]苏州大学附属第三医院影像科 [5]复旦大学附属中山医院放射诊断科

出　　处：《放射学实践》2016年第6期495-500,共6页Radiologic Practice

摘　　要：目的:总结非免疫缺陷病毒(AIDS)患者肺隐球菌病(PC)的CT表现,提高对该病的诊断能力。方法:回顺性分析4家医院2003年4月-2013年11月收治经病理学证实的非AIDS患者PC的CT影像资料39例。结果:39例PC患者中肺肿块/结节型占62%(24例),并以单发型最多见(46%,18例);混合型占21%(8例);肺实变型占15%(6例);弥漫型占3%(1例)。普通型及周围型分别占46%(18例)及38%(15例)。所有患者共检出可评估病灶75个,主要累及下肺区(65%,49个)。充气支气管征见于57%的肺肿块/结节(26个),其中Ⅲ型22个,假空洞征7个。磨玻璃影/晕征见于46%的肺肿块/结节(21个)及52%的肺实变(15个)。卫星灶见于33%(13例)的患者。结论:非AIDS患者PC的CT表现各异。肺单发/多发性肿块/结节主要位于下肺、胸膜下/接近胸膜下区域、周围磨玻璃影/晕征、Ⅲ型充气支气管征/假空洞征及卫星灶可能对诊断有帮助。Objective：To present the computed tomography（CT）manifestations of pulmonary cryptococcosis（PC）in non-AIDS patients and hence increase the confidence in the diagnosis of PC.Methods：CT imaging findings of PC proven histopathologically in 39 cases were reviewed retrospectively.All the cases were collected in four hospitals from April 2003 to November 2013 and all of them were non-AIDS patients.Results：The pulmonary mass/nodule pattern was the prevalent CT manifestation（62%,n=24patients）,in which a solitary lesion was the most common CT finding（46%,n=18patients）.This pattern was followed by mixed type（21%,n=8patients）,pulmonary consolidation（15%,n=6patients）and diffuse nodule pattern（3%,n=1patient）.The generalized transaxial distribution（46%,n=18patients）and the peripheral distribution（38%,n=15patients）were seen more.Seventy five measurable lesions,including 46mass/nodules and 29 pulmonary consolidations,were found in those 39 patients,which were mostly located in the lower pulmonary areas（65%,n=49lesions）.The sign of air-bronchogram（57%,n=26mass/nodule）was seen,in which typeⅢ was found in 22 lesions and the pseudocavity sign was found in 7lesions.The sign of ground glass opacity or halo was observed in PC 46% of mass/nodule lesions（n=21）and 52% of consolidations（n=15）.Satellite nodules were seen in 33% of patients（n=13）.Conclusion：The CT manifestations of PC in non-AIDS patients are complicated and varied.Those findings,including solitary/multiple pulmonary mass/nodule,being located in the lower lung area,aperipheral or generalized axial distribution,surrounding ground glass opacity or halo sign,air-bronchogram sign（typeⅢ）or pseudocavity sign in lesions,and satellite nodules,may aid in making a correct diagnosis.

关 键 词：肺 隐球菌病 体层摄影术 X线计算机 

分 类 号：R519.4[医药卫生—内科学] R816.41[医药卫生—临床医学]