获得性免疫缺陷综合征相关肺孢子菌肺炎的CT征象分析  

Analysis of CT signs of acquired immune deficiency syndrome-associated pneumocystis jirovecii pneumonia

作　　者：高雅 李刚锋 雷学斌 闫卫强 崔光彬 GAO Ya;LI Gangfeng;LEI Xuebin;YAN Weiqiang;CUI Guangbin(Department of Radiology,Tangdu Hospital,the Air Force Medical University,Xi’an 710038,China)

机构地区：[1]空军军医大学唐都医院放射科,陕西西安710038

出　　处：《实用放射学杂志》2023年第12期1949-1952,共4页Journal of Practical Radiology

摘　　要：目的探讨获得性免疫缺陷综合征(AIDS)相关肺孢子菌肺炎(PJP)的常见CT征象。方法回顾性分析123例AIDS相关PJP患者的胸部CT资料。结果所有病例均为双肺多发病变。分布特点:两肺弥漫对称性分布100例(81.3%),两肺弥漫不对称性分布15例(12.2%),两肺散在分布8例(6.5%)。密度、形态学表现:磨玻璃影120例(97.6%);“月弓征”25例(20.3%);肺间质增生103例(83.7%);铺路石征14例(11.4%);斑片、实变影55例(44.7%);肺气囊26例(21.1%);结节26例(21.1%);其他少见征象:胸膜腔积液11例,心包积液6例,纵隔、肺门淋巴结肿大9例,纵隔气肿1例。结论AIDS相关PJP患者的胸部CT表现具有一定特征,病变多双肺弥漫对称性分布,磨玻璃影和间质增生为常见征象,“月弓征”及肺气囊较具特异性。Objective To explore the common CT signs of acquired immune deficiency syndrome(AIDS)-associated pneumocystis jirovecii pneumonia(PJP).Methods The chest CT data of 123 patients with AIDS-associated PJP were analyzed retrospectively.Results Multifocal lesions in both lungs were found in all cases.Distribution characteristics were as follows:diffuse and symmetrical distribution in both lungs in 100 cases(81.3%),diffuse and asymmetrical distribution in both lungs in 15 cases(12.2%),and scattered distribution in both lungs in 8 cases(6.5%).The density and morphological features were as follows:ground glass opacity in 120 cases(97.6%);“lunate arch sign”in 25 cases(20.3%);pulmonary interstitial proliferation in 103 cases(83.7%);crazy paving pattern in 14 cases(11.4%);patchy or consolidation shadow in 55 cases(44.7%);pulmonary cysts in 26 cases(21.1%);and nodular in 26 cases(21.1%).Other rare signs included pleural effusion in 11 cases,pericardial effusion in 6 cases,mediastinal and hilar lymphadenopathy in 9 cases,and mediastinal emphysema in 1 case.Conclusion The chest CT manifestations of AIDS-associated PJP have certain characteristics,including diffuse and symmetrical distribution of lesions in both lungs,as well as ground glass opacity and interstitial hyperplasia as common signs,especially,“lunate arch sign”and pulmonary cysts are more specific signs.

关 键 词：获得性免疫缺陷综合征 肺孢子菌肺炎 计算机体层成像 

分 类 号：R512.91[医药卫生—内科学] R563.1[医药卫生—临床医学] R814.42