艾滋病合并卡氏肺孢子虫肺炎与其合并肺结核的CT诊断  

CT diagnosis of AIDS combined with pneumocystis carinii pneumonia and AIDS with tuberculosis

作　　者：岳炫彤 邬颖华[2] 王涛[1] 张荣萍[1] 周朝鑫 汪悦 杨阳[2] YUE Xuan-tong;WU Ying-hua;WANG Tao;ZHANG Rong-ping;ZHOU Chao-xin;WANG Yue;YANG Yang(Department of Radiology,the First People＇s Hospital of Liangshan Prefecture,Xichang Sichuan 615000,China;Chengdu University of TCM,Chengdu 610075,China)

机构地区：[1]凉山州第一人民医院放射科,四川西昌615000 [2]四川省成都中医药大学,四川成都610075

出　　处：《中国临床医学影像杂志》2018年第10期696-698,703,共4页Journal of China Clinic Medical Imaging

摘　　要：目的:探讨艾滋病(AIDS)合并卡氏肺孢子虫肺炎与AIDS合并肺结核的CT诊断与鉴别诊断。方法:回顾性分析经临床、影像诊断并治疗有效的16例AIDS合并卡氏肺孢子虫肺炎与36例AIDS合并肺结核患者的CT影像资料。结果:AIDS合并肺孢子虫肺炎为两肺多叶病变,以中央部或肺门对称性分布为著;AIDS合并肺结核病变主要双肺多叶受累,多数呈双肺散在分布,以非结核好发部位为著。两者在磨玻璃影、网格状/条索状影、结节影、纵隔淋巴结肿大及胸膜增厚等CT表现的差异具有统计学意义(P<0.05),其中磨玻璃影及网格状/条索状影AIDS合并卡氏肺孢子菌肺炎组多于AIDS合并肺结核组,而多发结节影、纵隔淋巴结肿大及胸膜增厚AIDS合并肺结核组多于AIDS合并卡氏肺孢子菌肺炎组。结论:AIDS合并卡氏肺孢子虫肺炎与其合并肺结核的胸部CT征象具有一定的特异性,有助于二者的CT诊断与鉴别诊断。Objective： To explore the CT diagnosis and differential diagnosis of acquired immune deficiency syndrome（AIDS） combined with pneumocystis carinii pneumonia（PCP） and AIDS with tuberculosis（TB）. Methods： The CT images of 16 cases of AIDS combined with PCP and 36 cases of AIDS combined with TB were analyzed retrospectively. Results： PCP patients with AIDS all showed two pulmonary multilobed lesions, with the distribution of central or pulmonary hilum symmetry.TB patients with AIDS mainly involved multiple lobes of both lungs, with non tuberculous predilection sites. There were significant differences in CT findings such as ground glass shadow, grid/stripe shadow, nodule shadow, mediastinal lymph node enlargement and pleural thickening（P〈0.05）, in which the ground glass shadow and grid/stripe shadow in group PCP were more than those in group TB, while the multiple nodules, mediastinal lymph node enlargement and pleural thickening in group TB were more than those in group PCP. Conclusion： The CT manifestations of AIDS with PCP and AIDS with TB have certain specificity, which is helpful for CT diagnosis and differential diagnosis.

关 键 词：获得性免疫缺陷综合征 肺炎 肺囊虫性 结核 肺 体层摄影术 X线计算机 

分 类 号：R512.91[医药卫生—内科学] R563.1[医药卫生—临床医学]