210例耐甲氧西林金黄色葡萄球菌肺炎的CT征象分析  

CT Findings of 210 Cases with Methicillin Resistant Staphylococcus Aureus Pneumonia

作　　者：张金娥[1] 赵振军[1] ZHANG Jine;ZHAO Zhenjun(Guangdong General Hospital,Guangdong Academic of Medical Science,Guangzhou 510080,P.R.China)

机构地区：[1]广东省人民医院/广东省医学科学院

出　　处：《临床放射学杂志》2018年第8期1298-1302,共5页Journal of Clinical Radiology

摘　　要：目的探讨耐甲氧西林金黄色葡萄球菌（MRSA）肺炎的CT征象特点。方法回顾性分析210例MRSA肺炎的CT征象,总结MRSA肺炎的CT特征性表现。结果 210例患者,64例血培养阳性,146例痰培养阳性。47例为社区获得性MRSA（CA-MRSA）,163例为院内感染MRSA（HA-MRSA）。显示的CT征象：203例肺实变,147例磨玻璃影,49例多发肺结节,119例空洞伴气-液平面,空洞壁环形强化,5例肺气囊,135例胸腔积液,3例肺脓肿胸腔瘘,2例纵隔脓肿,3例气胸和皮下气肿。血培养阳性患者及痰培养阳性患者CT实变、磨玻璃影征象的出现率比较无统计学意义（P〉0.05）;结节、空洞和胸腔积液征象的出现率比较有统计学意义（P〈0.05）。CA-MRSA及HA-MRSA两组患者实变和磨玻璃影征象的出现率无统计学意义（P〉0.05）;CA-MRSA空洞的出现率高于HAMRSA（P〈0.05）,而HA-MRSA结节和胸腔积液的出现率高于CA-MRSA（P〈0.05）。结论 MRSA肺炎的CT征象具有一定的特征,CT检查有助于早期诊断。Objective To analyse CT findings of 210 cases with methicillin resitant staphylococcus aureus（ MRSA）pneumonia. Methods The CT images of 210 cases with MRSA pneumonia were analyzed retrospectively. Results 64 cases of positive blood culture and 146 cases of positive sputum culture in 210 cases MRSA pneumonia. 47 cases CA-MRSA and 163 cases HA-MRSA. 203 cases displayed consolidation,147 cases showed ground grass attenuation,49 cases had multiple pulmonary nodules,119 cases presented as cavity with gas-liquid plane inside and ring-enhancement of the wall,135 cases pleural effusion,5 cases pneumonocele,3 cases pulmonary abscess and thoracic fistula,2 cases mediastinal abscess and 3 cases pneumothorax with cutaneous emphysema. No statistical differences were found in consolidation and ground grass attenuation between positive blood culture and positive sputum culture（ P 0. 05）. Nodule、cavity and hydrothorax appeared more easily in positive blood culture. Cavity appeared more readily in CA-MRSA and nodule and hydrothorax appeared more easily observed in HA-MRSA. Conclusion There are characteristic CT signs in methicillin resistant staphylococcus aureus pneumonia,CT scanning is helpful for early diagnosis.

关 键 词：耐甲氧西林金黄色葡萄球菌 肺 体层摄影术 X线计算机 

分 类 号：R563.1[医药卫生—呼吸系统]