肺隐球菌病CT征象分析  

CT analysis of pulmonary cryptococcosis

作　　者：吕军[1] 张洪[1] 马延贺[1] 

机构地区：[1]天津市胸科医院放射科,天津300222

出　　处：《实用放射学杂志》2017年第3期382-384,388,共4页Journal of Practical Radiology

基　　金：天津市卫生局自然科学基金项目（2012KZ055）.

摘　　要：目的 分析经病理证实的肺隐球菌病（PC）的CT影像表现,加深对本病影像征象的认识及提高诊断水平.方法 回顾性分析经穿刺或手术病理证实的19例PC患者的CT影像及临床资料.结果 ①结节或肿块型10例,结节型多见,直径1-2.5 cm,多发结节易融合.斑片、实变浸润型6例,所见斑片或实变的密度较炎性斑片高,边界多清楚.双肺病灶多为一侧为主,另一侧受累.混合型3例,表现为结节、实变及磨玻璃影等混合存在,均为双肺分布.②病灶分布特点为下肺分布（47%）及胸膜下分布（68%）,多为轻-中度强化.③19例患者中,出现影像征象依次为胸膜增厚8例（42%）,支气管气相7例（36%）,晕轮征5例（26%）,空洞4例（21%）.结论 PC的CT表现具有多样性.①病灶以下肺及近胸膜分布多见.②病变多为轻-中度强化.③胸膜增厚、支气管气相、晕轮征、空洞等征象对诊断有一定提示意义.Objective To review and analyse the CT distinguishing features of pulmonary cryptococcosis （PC）for improving the level of image diagnosis of the disease.Methods CT images and clinical details of 19 patients with biopsy or surgery pathology con-firmed PC were reviewed and analysed.Results Nodules or masses were presented in 10 cases,in which most casescases were nod-ules,lesions ranged in diameter from 1 cm to 2.5 cm.Multiple nodules were easy to fuse.Consolidation were presented in 6 cases,with high attenuation and clear border.3 cases were mixed type,with nodule,mass consolidation and ground glass attenuation.The lesions were mostly located in the inferior lobes（47%）and peripheral lung（68%）.The features of pleural thickening,air bronchus sign,halo sign and cavitations were observed in 42%,36%,26%,21% of patients respectively.Conclusion CT findings of PC are diversity.The lesions are mostly located in the inferior and peripheral lung.Lesions are mild to moderate enhanced.Pleural thickening,air bronchus sign,halo sign,cavitations will be useful for the diagnosis.

关 键 词：肺隐球菌病 计算机体层成像 

分 类 号：R563[医药卫生—呼吸系统] R814.42[医药卫生—内科学]