慢性阻塞性肺疾病合并侵袭性肺曲霉菌病胸部CT分析  

CT manifestations of chronic obstructive pulmonary disease with invasive pulmonary aspergillosis

作　　者：李萍[1] 杨利莉[2] 王正亚 耑冰[1] LI Ping;YANG Lili;WANG Zhengya;ZHUAN Bing(Department of Respiratory Medicine,Ningxia Autonomous Region People’s Hospital,Yinchuan 750002,China;Department of Radiology,Ningxia Autonomous Region People’s Hospital,Yinchuan 750002,China;Northwest Minzu University,Lanzhou 730030,China)

机构地区：[1]宁夏回族自治区人民医院呼吸内科,宁夏银川750002 [2]宁夏回族自治区人民医院放射科,宁夏银川750002 [3]西北民族大学,甘肃兰州730030

出　　处：《实用放射学杂志》2021年第9期1426-1428,1440,共4页Journal of Practical Radiology

基　　金：北方民族大学科学研究项目(2019YXKY03);西北民族大学临床教学基地2019年度中央高校基本科研业务费项目(31920190183).

摘　　要：目的评估胸部CT检查在慢性阻塞性肺疾病(COPD)合并侵袭性肺曲霉菌病(IPA)的诊断价值.方法通过单中心病例对照回顾性研究,对比分析36例COPD合并IPA患者及36例单纯COPD患者的胸部CT表现.结果COPD合并IPA患者胸部CT,在肺气肿等病变基础上,出现新的病灶;多数病灶沿血管、支气管束分布(69.44%),其次为沿胸膜分布(41.67%);主要表现为支气管壁增厚(80.56%)、斑片渗出影(77.78%),其次为肺磨玻璃影(38.89%)、结节影(38.89%)、单发或多发空洞(36.11%)、树芽征(27.78%)、晕征(22.22%),典型的“空气新月征”(11.11%)、胸膜下楔形实变(5.56%)少见.结论胸部CT检查能够帮助更早的识别COPD患者是否合并IPA,胸部CT检查若出现支气管壁增厚、沿支气管血管束分布的斑片渗出影、磨玻璃影、结节影等气道侵袭征象,可为COPD合并IPA提供诊断依据.Objective To access the diagnostic value of chest CT in chronic obstructive pulmonary disease(COPD)with invasive pulmonary aspergillosis(IPA).Methods The chest CT findings of 36 patients with COPD complicated with IPA were retrospectively compared with other 36 cases diagnosed as COPD in a single-center case-control study.ResuIts Except the basis of pulmonary emphysema and other pathological changes in chest CT for patients diagnosed as COPD with IPA,flowing new lesions appeared:most of those distributed along blood vessels and bronchioles(69.44%)and the second was along the pleura(41.67%).The most outstanding performances of the new lesions were bronchial wall thickening(80.56%)and spot exudation oppacity(77.78%)on CT.And others appearances were ground glass opacity(38.89%).nodules(38.89%).single or multiple cavities(36.11%).tree in bud sign(27.78%).halo sign(22.22%).typical air crescent sign(11.11%).and rare subpleural wedge-like consolidation(5.56%).Conclusion Chest CT examination can help to identify IPA in patients with COPD earlier.If chest CT there are signs of airway invasion such as bronchial wall thickening,patchy exudation,ground glass opacity,and nodules distributed along the bronchial vascular bundle.it can provide diagnostic basis for COPD combined with IPA.

关 键 词：慢性阻塞性肺疾病 侵袭性肺曲霉菌病 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]