免疫功能正常者肺奴卡菌病的高分辨CT影像特征  

High-resolution CT image characteristics of lung nocardiosis in patients with normal immune function

作　　者：田欣[1] 朱芳华[2] 宋鹏[1] 耿左军[1] 胡婧 刘怀军[1] 卜静英[1] TIAN Xin;ZHU Fanghua;SONG Peng;GENG Zuojun;LIU Huaijun;PU Jingying(Department of Medical Image,The Second Hospital of Hebei Medical University,Hebei,Shijiazhuang 050000,China)

机构地区：[1]河北医科大学第二医院医学影像科,石家庄市050000 [2]河北省医学情报研究所

出　　处：《河北医药》2018年第8期1191-1194,共4页Hebei Medical Journal

摘　　要：目的探讨免疫功能正常者肺奴卡菌病的高分辨CT影像特征,以助早期诊断。方法回顾性分析35例肺奴卡菌病患者CT图像特征。35例患者中,女20例,男15例;年龄49~80岁,平均年龄61岁。所有患者均没有服用免疫抑制剂史和免疫抑制疾病。所有病例样本菌种鉴定均采用传统生化反应实验与全细胞脂肪酸气相色谱分析法相结合进行。所有患者均行高分辨CT检查。结果 35例均表现为多发肺部实变区,按小叶分布的结节及磨玻璃影。35例均可见空气支气管征,支气管管壁增厚和管腔扩张。8例表现为空洞结节,结节直径超过1 cm。结论免疫功能正常者肺奴卡菌CT表现以实变、结节、磨玻璃影为主,空洞少见,常伴有支气管扩张、管壁增厚,如患者应用头孢类等抗生素治疗无效时,应结合胸部CT特征,考虑到肺奴卡菌肺炎的诊断。Objective To investigate the high-resolution CT image characteristics of lung nocardiosis in patients with normal immune function in order to make early diagnosis.Methods The CT image features of 35 patients with lung nocardiosis were retrospectively analyzed,in whom,there were 20 females and 15 males,with age range being 49~80 years(average 61 years).All the patients had no history of immunosuppressive agents therapy and any immunosuppressive diseases.The traditional biochemical reaction experiments combined with total cell fatty acid gas chromatography(GC)analysis were used to determine the type of infection bacteria.Moreover all the patients underwent high resolution CT scanning.Results CT images showed pulmonary consolidation region in all the cases,with nodules and/or ground glass opacities,which distributed according to lobuli pulmonum,moreover,which also showed air bronchus sign,thickened wall and enlarged lumen of bronchioles in 35 patients.Besides there were multiple nodules with cavities and the diameter of nodules was larger than 1cm in 8 patients.Conclusion In normal immunocompetent patients with lung nocardiosis,the opacity,nodule and ground glass opacity are main features of CT images,and cavity is not a common finding.Therefor,if cephalosporin is not effective,the diagnosis of nocardia pneumonia should be considered.

关 键 词：免疫正常 奴卡菌肺炎 CT 

分 类 号：R445.3[医药卫生—影像医学与核医学]