肺隐球菌病的CT影像表现  

CT appearance of pulmonary cryptococcosis

作　　者：冯瑞枝 林波淼[1] 梁文[1] 田霞辉 袁阳光[1] 

机构地区：[1]南方医科大学珠江医院影像诊断科,广东广州510282 [2]东莞市第三人民医院影像科,广东广州523326

出　　处：《临床肺科杂志》2016年第11期1986-1989,共4页Journal of Clinical Pulmonary Medicine

摘　　要：目的探讨肺隐球菌病(pulmonary cryptococcosis,PC)的CT影像表现,加强对本病认识,提高诊断水平,减少误诊。方法搜集本院2008至2015年间经病理确诊的26例PC患者的CT影像表现进行分析。结果 26例PC患者中,男14例,女12例,年龄31-65岁,中位年龄48岁。CT表现形态多样:(1)孤立结节或肿块型7例;(2)多发结节或肿块型7例;(3)实变型1例;(4)弥漫混合型11例。所有结节或实变均位于肺外带,呈聚集分布,结节或肿块边缘不规则,所有病例未见钙化,有20例病灶内见支气管充气征,11例出现厚壁空洞,11例呈宽基底状紧贴胸膜,4例周边出现"晕征",2例小结节出现"胸膜凹陷征"。增强扫描:3例出现不均一强化,内见散在低密度坏死灶;1例孤立结节呈周边强化,中间密度稍低;2例实性结节呈均一强化。结论 PC的CT表现形态多样,病灶位于肺外带,呈聚集分布,病变内部多见支气管充气征,呈宽基底向外紧贴胸膜,厚壁空洞。Objective To investigate the CT imaging features of pulmonary cryptococcosis （ PC） , in order to strengthen the understanding of the disease and improve the diagnostic level and reduce the misdiagnosis rate. Meth-ods CT images of 26 patients with PC confirmed by pathology were collected and analyzed in our hospital from 2008 to 2015. Results The 26 cases with PC included 14 males and 12 females, aged from 31 to 65 years, with a median age of 48. CT appearances were various, 7 cases showed solitary nodule, 7 cases showed multiple nodules, 1 case showed lobar consolidation, and 11 cases were diffuse mixed pattern. All the lesions with irregular margin were aggre-gately located at the periphery of lung. Calcification could not be seen in any cases. Air bronchogram could be seen in 20 cases. 11 cases had thick-walled cavity. 11 cases showed a wide base shape outwardly close to the pleura, 4 cases were surrounded by the“halo sign”, and 2 small nodules revealed pleural indentation sign. The enhanced scan showed 3 cases with uneven enhancement with low density necrotic foci scattered. 1 solitary nodule with slightly lower intermediate density, and 2 solid nodules. Conclusion Although the CT appearance of PC are various, they often aggregately located at the periphery of lung with air bronchogram sign, thick-walled cavity, and wide base shape out-wardly close to the pleura.

关 键 词：肺 隐球菌 病理 计算机体层成像 

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