急性肺组织胞浆菌病CT表现  

CT findings of acute pulmonary histoplasmosis

作　　者：刘雪艳[1,2] 李春华 舒伟强[1] 王惠秋 杨佳[1] 唐光孝[1] 戴欣 邓静[1] 严晓峰 吕圣秀[1] 李咏梅 LIU Xueyan;LI Chunhua;SHU Weiqiang;WANG Huiqiu;YANG Jia;TANG Guangxiao;DAI Xin;DENG Jing;YAN Xiaofeng;LYU Shengxiu;LI Yongmei(Department of Medical Imaging,Chongqing Public Health Medical Center,Chongqing 400036,China;Department of Radiology,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China;Department of Tuberculosis,Chongqing Public Health Medical Center,Chongqing 400036,China)

机构地区：[1]重庆市公共卫生医疗救治中心医学影像科,重庆400016 [2]重庆医科大学附属第一医院放射科,重庆400016 [3]重庆市公共卫生医疗救治中心结核科,重庆400036

出　　处：《中国医学影像技术》2020年第11期1643-1647,共5页Chinese Journal of Medical Imaging Technology

基　　金：“十三五”国家科技重大专项(2018ZX10302104);重庆市公共卫生医疗救治中心青年科研创新项目(2019QNKYXM07)。

摘　　要：目的观察急性肺组织胞浆菌病的胸部CT表现及其治疗期间动态变化特征。方法回顾性分析10例急性肺组织胞浆菌病患者,观察其首次CT表现及动态变化特征。结果首次胸部CT于10例(10/10,100%)均见多发肺结节,周围伴晕征;其中4例(4/10,40.00%)病变弥漫分布(弥漫分布组),6例(6/10,60.00%)散在分布(散在分布组)。10例中,4例(4/10,40.00%)见斑片或大片状影,3例(3/10,30.00%)见片状磨玻璃影。10例(10/10,100%)纵隔淋巴结均增大,8例(8/10,80%)伴肺门淋巴结增大;4例(4/10,40.00%)存在小叶间隔增厚;5例(5/10,50%)出现浆膜腔积液。弥漫分布组与散在分布组间组织胞浆菌暴露时长、住院时长及首次CD4+细胞计数差异均有统计学意义(Z=-2.03、-2.35、-2.34,P均<0.05)。治疗过程中,2例(2/10,20.00%)病变持续吸收好转,8例(8/10,80.00%)先后出现病变进展;治疗3个月后病变均好转。结论急性肺组织胞浆菌病的胸部CT表现具有一定特征性,治疗前及治疗过程行胸部CT有助于诊断、鉴别诊断及评价疗效。Objective To observe CT manifestations of acute pulmonary histoplasmosis and dynamic changes during therapeutic periods.Methods Clinical and chest CT data of 10 patients with acute pulmonary histoplasmosis were retrospectively analyzed.The initial chest CT manifestations and dynamic changes during therapeutic periods were observed.Results Initial chest CT included pulmonary nodules with halo sign in all 10 cases(10/10,100%),which diffuse distributed in 4 cases(4/10,40%,diffuse distribution group)and scattered distributed in 6 cases(6/10,60%,scattered distribution group).Patches or large patches shadows were observed in 4 cases(4/10,40%),while ground-glass opacities were found in 3 cases(3/10,30%).All 10 patients(10/10,100%)showed enlarged mediastinal lymph nodes,8(8/10,80%)accompanied by enlarged hilar lymph nodes.Septa interlobular thickening was detected in 4 cases(4/10,40%),while serous cavity effusion was noticed in 5 cases(5/10,50%).There were statistically differences of histoplasmosis exposure duration,hospitalization time and initial CD4+cell count between diffuse distribution group and scattered distribution group(Z=-2.03,-2.35,-2.34,all P<0.05).During therapeutic periods,continuous improvement of lesions occurred in 2 cases(2/10,20%),while lesion progression happened at different time in 8 patients(8/10,80%).Three months after treatment,improvements were observed in all 10 cases.Conclusion Chest CT manifestations of acute pulmonary histoplasmosis had certain characteristics.Chest CT examination before and during treatment were helpful to diagnosis,differential diagnosis and evaluation on curative effects.

关 键 词：肺 组织胞浆菌病 诊断 体层摄影技术 X线计算机 

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