变态反应性支气管肺曲霉菌病高分辨率CT回顾性分析  

Retrospective high-resolution CT analysis of allergic bronchopulmonary aspergillosis

作　　者：宋敏[1] 倪丰 Song Min;Ni Feng(Department of Radiology,Dalian Second People′s Hospital,Dalian 116011,China;Department of Radiology,Nanjing Lishui District Hospital of Traditional Chinese Medicine,Nanjing 211200,China)

机构地区：[1]大连市第二人民医院影像科,116011 [2]南京市溧水区中医院影像科,211200

出　　处：《中国医师进修杂志》2020年第3期220-224,共5页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨变态反应性支气管肺曲霉菌病(ABPA)的高分辨率CT(HRCT)影像特点,提高诊断准确率。方法回顾分析2010年1月至2018年6月大连市第二人民医院及南京市溧水区中医院确诊的21例ABPA患者的临床资料,对其临床表现、HRCT检查等进行统计分析,总结HRCT影像表现。结果21例患者中,以咳嗽咳痰以及喘闷为主要临床症状,其次为发热、咯血等;有药物或食物过敏史5例。ABPA在HRCT上表现中心型支气管扩张18例,其中单纯支气管扩张10例、伴有低密度支气管黏液栓形成9例、伴高密度支气管黏液栓形成6例;11例可见斑片状实变浸润影;2例可见肿块影;3例可见小叶中心结节及树芽征;6例纵隔淋巴结增大。结论ABPA的HRCT影像诊断困难,中心性支气管扩张伴有高密度黏液栓形成具有一定的特征性,可作为ABPA影像诊断的可靠依据,结合临床及实验室检查,一般可明确诊断。Objective To investigate the high-resolution CT(HRCT)imaging characteristics of allergic bronchopulmonary aspergillosis(ABPA)to improve the diagnostic accuracy.Methods The clinical data of 21 patients with ABPA diagnosed in Dalian Second People′s Hospital and Nanjing Lishui District Hospital of Traditional Chinese Medicine from January 2010 to June 2018 were retrospectively analyzed,and their clinical manifestations and HRCT examinations were statistically analyzed to summarize the HRCT imaging manifestations.Results Among the 21 patients,cough,expectoration and wheezing were the main clinical symptoms,followed by fever and hemoptysis;5 patients had a history of drug or food allergy.ABPA showed 18 cases of central bronchiectasis on HRCT,including 10 cases of simple bronchiectasis,9 cases with low-attenuation mucus,and 6 cases with high-attenuation mucus;patchy consolidation infiltration were seen in 11 cases;masses were seen in 2 cases;central nodules and tree buds were seen in 3 cases;mediastinal lymph nodes were enlarged in 6 cases.Conclusions HRCT imaging of ABPA is difficult to diagnose,and central bronchiectasis with high-attenuation mucus is characteristic.It can be used as a reliable basis for the diagnosis of ABPA imaging.Combined with clinical and laboratory examinations,it can generally be diagnosed clearly.

关 键 词：曲霉菌病 变应性支气管肺 高密度黏液栓 计算机体层成像 

分 类 号：R816[医药卫生—放射医学] R51[医药卫生—临床医学]