鹦鹉热衣原体肺炎的胸部CT影像表现  

Chest CT imaging features of Chlamydia psittaci pneumonia

作　　者：朱巧[1] 任翠 李美娇 王晓华[1] ZHU Qiao;REN Cui;LI Mei-jiao(Department of Radiology,the Third Hospital of Peking University,Beijing 100083,China)

机构地区：[1]北京大学第三医院放射科,北京100191

出　　处：《放射学实践》2024年第2期201-206,共6页Radiologic Practice

基　　金：北京大学第三医院临床重点项目孵育项目A类资助项目(BYSYZD2021018)。

摘　　要：目的:探讨鹦鹉热衣原体肺炎的胸部CT影像表现。方法:回顾性分析22例鹦鹉热衣原体肺炎患者的临床及胸部CT资料,分析肺内病变的影像学特点及肺外影像表现。结果:22例鹦鹉热衣原体肺炎中,15例肺内病变表现为大叶性肺炎,5例表现为斑片结节,2例表现为支气管肺炎,常见伴随征象包括:小叶间隔增厚(12例)、小叶内网状影(11例)、铺路石征(6例),少数可见晕征(3例)、反晕征(1例)、小叶中心性结节(1例)、支气管壁增厚(2例)、支气管牵引性扩张(1例)。所有病变均未见坏死或空洞。肺内病变分布:累及单肺19例,双肺3例;累及上肺区6例,下肺区13例,上、下肺区同时受累3例;外周分布12例,支气管血管周围分布4例,弥漫分布6例。10例合并胸腔积液,3例伴纵隔淋巴结增大。结论:鹦鹉热衣原体肺炎的影像表现以大叶性肺炎最多见,典型者表现为斑片状实变伴空气支气管征,多合并磨玻璃密度影,常伴小叶间隔增厚、小叶内网状影及铺路石征等间质受累表现,可见胸腔积液、纵隔淋巴结增大。Objective:To explore the chest CT imaging features of Chlamydia psittaci(C.psittaci)pneumonia.Methods:A retrospective analysis was performed on the clinical and chest CT data of 22 patients with C.psittaci pneumonia,analyzing the imaging characteristics of pulmonary lesions and extrapulmonary manifestations.Results:Among the 22 cases of C.psittaci pneumonia,the intrapulmonary lesions showed a lobar pneumonia pattern in 15 cases,a patchy nodular pattern in 5 cases,and a bronchopneumonia pattern in 2 cases.All cases exhibited air bronchogram sign,and common accompanying signs included thickening of interlobular septa(12 cases),intralobular reticular pattern(11 cases),crazy paving sign(6 cases),halo sign(3 cases),reverse halo sign(1 case),centrilobular nodule(1 case),thickening of bronchial walls(2 cases),and tractive bronchiectasis(1 case).No necrosis or cavitation was observed in any of the lesions.Pulmonary lesions were distributed in 19 cases in a single lung and 3 cases in both lungs.Six cases involved the upper lung region,13 cases involved the lower lung region,and 3 cases involved both regions simultaneously.Twelve cases had peripheral distribution,4 cases had peribronchovascular distribution,and 6 cases had diffuse distribution.Ten cases had associated pleural effusion,and 3 cases had enlarged mediastinal lymph nodes.Conclusion:The imaging manifestations of C.psittaci pneumonia most commonly characterized by a lobar pneumonia pattern,often accompanied by ground-glass opacities.Interstitial involvement is also common,with thickening of interlobular septa,intralobular reticular pattern,and crazy paving sign.Pleural effusion and mediastinal lymphadenopathy may also be observed.

关 键 词：鹦鹉热衣原体 肺炎 体层摄影术 X线计算机 

分 类 号：R814.42[医药卫生—影像医学与核医学] R563.1[医药卫生—放射医学]