新型隐球菌肺炎患者的X线与多层螺旋CT临床诊断分析  

Clinical study of X-ray and multi-slice spiral CT in the diagnosis of novel pulmonary cryptococcosis

作　　者：吴敏芳[1] 黄求理[1] 张杰[1] 蔡志琴[1] 李峰[2] 

机构地区：[1]宁波市第一医院放射科,浙江宁波315700 [2]宁波市第二医院放射科,浙江宁波315010

出　　处：《中华医院感染学杂志》2017年第16期3643-3646,共4页Chinese Journal of Nosocomiology

基　　金：浙江省医药卫生研究计划基金资助项目(2014KYA170)

摘　　要：目的探讨X线和多层螺旋CT对新型隐球菌肺炎患者的临床诊断价值。方法选取医院2015年1月-2016年12月收治的76例新型隐球菌肺炎患者,40例为螺旋CT检查组,行X线检查的患者36例为X线检查组,比较两种方法的诊断价值。结果 76例新型隐球菌肺炎患者微生物培养阳性65例,阳性率85.53%;76例隐球菌肺炎中病变位于双侧肺部41例,肺叶下部43例,肺部外周46例;CT检查组在磨玻璃影、空洞、晕征、空气支气管征、肿大淋巴结、分叶及合并网格影等征象的检出率方面均显著高于X线检查组,差异有统计学意义(P<0.05);CT检查组在结节/肿块型、实变型、肺炎样浸润型、空洞型、混合型等方面的检出率高于X线检查组,且差异有统计学意义(P<0.05)。结论微生物培养阳性率高,可以作为新型隐球菌肺炎的一种诊断方法;CT检查在新型隐球菌肺炎中诊断价值高于胸部X线检查,更值得在临床推广应用;确诊有赖于纤维支气管镜或穿刺活检病理证实。OBJECTIVE To investigate the clinical value of X-ray and multi-slice spiral CT in the diagnosis of novel pulmonary cryptococcosis. METHODS A total of 76 patients with novel pulmonary cryptococcosis were selected in our hospital from Jan. 2015 to Dec. 2016. Among them, 40 patients received multi-slice spiral CT examination, and 36 patients received X-ray examination. Diagnostic value of the two methods was compared. RESULTS There were 65 patients with positive microbiological cultures among 76 patients with pulmonary cryptococcosis, and the positive rate was 85.53%. Totally 41 lesions were located in of lung, and 46 lesions were located in the periphery of lung. frosted glass shadow, cavity, halo signs, air bronchogram, both lungs, 43 lesions were located in the lower lobe As comparison of indications, the detection rates of mediastinal lymphadenopathy, leaf sign and merge grid shadow of multi-slice spiral CT examination were significntly higher than those of X-ray examination （P〈0.05）. The detection rates of nodular/mass, pneumonic, infiltrative, solid, cavitary, and mixed, of multi-slice spiral CT examination were significntly higher than those of X-ray examination （P〈0.05） . CONCLUSION The positive rate was high in the microbiological cultures, and it can be used as a diagnostic method for pulmonary cryptocoecosis. Multi-slice spiral CT examination has a higher diagnostic value than X-ray examination in the diag- nosis of pulmonary cryptococcosis, and it is worthy of clinical application. The correct diagnosis depends on his- topathologic by fiberoptic bronehoscopy or needle biopsy examination.

关 键 词：新型隐球菌肺炎 X线 多层螺旋CT 诊断价值 

分 类 号：R563.1[医药卫生—呼吸系统]