以双肺多发空洞为主要表现的曲菌病及肺结核CT鉴别诊断  

CT Differential Diagnosis on Aspergillosis and Pulmonary Tuberculosis Presenting with Bilateral Pulmonary Multiple Cavity

作　　者：陈立鹏[1] 刘灶松[1] 陈亮[1] 魏新华[1] 刘伟锋[1] CHEN Li-peng;LIU Zao-song;CHEN Liang(Department of Radiology,Guangzhou First People's Hospital,Guangzhou Medical University,Guangzhou 510180,Guangdong Province,China)

机构地区：[1]广州市第一人民医院放射科,广东广州510180

出　　处：《中国CT和MRI杂志》2018年第1期60-62,共3页Chinese Journal of CT and MRI

摘　　要：目的分析以双肺多发空洞为主要表现的曲菌病及肺结核的CT特点,以提高其诊断和鉴别诊断水平。方法收集确诊的肺部多发空洞病例57例,其中肺结核36例,肺曲菌病21例,分析其肺部多发空洞的CT征象,比较两组空洞的分布、晕征、空气新月征、空洞内菌丝、偏心空洞、虫蚀样空洞、引流支气管、卫星灶等出现率的差异,进行统计学分析,并分析比较两者肺内伴随影像学表现及病灶动态变化。结果两组病例肺部多发空洞在分布、形态、肺内伴随影像学表现及病灶动态变化均有差异,对空洞形态相关征象出现率行χ~2检验,有显著差异(P<0.05);肺曲菌病空洞的特点主要是晕征、空气半月征、空洞内菌丝,肺内伴随曲菌感染表现,病灶变化快;肺结核空洞的特点主要是多分布于两肺上叶尖后段和下叶背段、偏心空洞、虫蚀样空洞、引流支气管、卫星灶,肺内伴有结核感染表现,病灶变化较慢。结论 CT检查有助于鉴别以双肺多发空洞为主要表现的肺曲菌病和肺结核,有重要的临床应用价值。Objective To improve diagnosis and differential diagnosis through analyzing the CT characteristics of aspergillosis and pulmonary tuberculosis presenting with bilateral pulmonary multiple cavity.Methods 557 cases of patients with bilateral pulmonary multiple cavities were selected,in which 36 cases were pulmonary tuberculosis and 21 cases were pulmonary aspergillosis.Analyze the CT signs by comparing the distribution of cavities as well as occurrence difference of halo sign,air crescent sign,mycelia in cavities,eccentric cavity,worm-eaten cavity,drainage bronchus and satellite lesions in two groups to carry out statistic analysis,furthermore,compare and analyze pulmonary accompanying radiological performances and lesion dynamic changes between two groups.Results there were differences in distribution,shape,accompanying radiological performances and lesion dynamic changes of pulmonary multiple cavities between two groups.χ2 test was carried out in analyzing occurrence rate of signs relevant to cavity shape,the result had significant difference(P<0.05),main characteristics of pulmonary aspergillosis cavity were halo sign,air crescent sign,mycelia in cavities,with pulmonary aspergillums infection and rapid lesion changes;main characteristics of pulmonary tuberculosis cavity were main locating in superior lobe apicoposterior segment and lower lobe dorsal segment of bilateral lungs,eccentric cavity,worm-eaten cavity,drainage bronchus and satellite lesions,with pulmonary tuberculosis infection and slow lesion changes.Conclusion CT inspection contributes to differentiate aspergillosis and pulmonary tuberculosis presenting with bilateral pulmonary multiple cavities,therefore,it was of great importance in clinical application value.

关 键 词：肺曲菌病 肺结核 空洞 计算机体层成像 

分 类 号：R445.3[医药卫生—影像医学与核医学] R563.9[医药卫生—诊断学]