肺隐球菌病临床特征与胸部CT表现的相关性研究  

Study on the correlation between clinical features and chest CT findings of pulmonary cryptococcosis

作　　者：赖添福 朱志强[1] 林裕霖[1] 刘晋发 LAI Tianfu;ZHU Zhiqiang;LIN Yulin;LIU Jinfa(Department of Radiology,Meizhou People’s Hos pital,Meizhou,Guangdong Province 514031,China;Department of Pathology,Meizhou People’s Hos pital,Meizhou,Guangdong Province 514031,China)

机构地区：[1]梅州市人民医院放射科,广东梅州514031 [2]梅州市人民医院病理科,广东梅州514031

出　　处：《实用放射学杂志》2020年第6期897-900,共4页Journal of Practical Radiology

摘　　要：目的回顾性分析肺隐球菌病(PC)患者临床特征与胸部CT表现之间的相关性。方法选取30例病理诊断PC病例,分析年龄(≥60岁)、有无症状、有无基础病变及常规实验室检查(白细胞、血红蛋白、血小板、C-反应蛋白)与胸部CT表现的相关性。结果PC以右肺(17/30)多见,好发于下肺(18/30),以多发病灶为主(21/30),表现为胸膜下宽基底(22/30),轻、中度强化(25/26),病灶边缘可见近端支气管征(14/30)、晕征(13/30)、反晕征(7/30)、空洞/空泡(4/30)。有无基础疾病PC的CT表现差异有统计学意义(χ2=6.09,P=0.048),有基础病变PC的CT表现以斑片浸润型为主,占57.85%;无基础病变PC的CT表现以结节/肿块型为主,占84.62%。结论PC在CT上主要表现为胸膜下宽基底结节/肿块或斑片浸润型轻中度强化病灶,可见近端支气管征、晕征、反晕征及空洞/空泡征。有基础病变患者以斑片浸润型为主;无基础病变以结节/肿块型为主。Objective To retrospectively analyze the correlation between clinical features and chest CT findings in the patients with pulmonary cryptococcosis(PC).Methods 30 patients with PC diagnosed by pathology were collected.And the correlation between age(≥60 years old),symptoms,basic lesions and routine laboratory examinations(white blood cells,hemoglobin,platelets,C-reactive protein)and chest CT findings was analyzed.Results PC mostly occurred in the right lung(17/30),especially in the lower lung(18/30)and mainly with multiple lesions(21/30),which showed wide subpleural basement(22/30),mild or moderate enhancement(25/26).Proximal bronchial sign(14/30),halo sign(13/30),reverse halo sign(7/30)and cavity/vacuole(4/30)could be found at the edge of the lesion.The different CT manifestations of PC with or without underlying diseases was statistically significant(χ2=6.09,P=0.048).Patch infiltration was the main CT manifestation of PC with underlying diseases(accounting for 57.85%),while nodule/mass was for PC without underlying diseases(accounting for 84.62%).Conclusion PC is mainly characterized on CT subpleural broad basal nodules/masses or patchy infiltrating with mild and moderate enhancement.Proximal bronchial sign,halo sign,reverse halo sign and cavity/vacuole sign can be seen.Patch infiltration is the main type in patients with underlying lesions,while nodule/mass is in patients without underlying lesions.

关 键 词：肺隐球菌病 晕征 病理学 计算机体层成像 

分 类 号：R563[医药卫生—呼吸系统] R814.42[医药卫生—内科学]