肺侵袭性真菌病及细菌性肺炎高分辨率CT的临床比较研究  

Comparative Study of High Resolution CT in Invasive Fungal Disease and Bacterial Pneumonia

作　　者：蓝芬[1] 吴天琼[2] 钟莹[1] LAN Fen;WU tian-qiong;ZHONG Ying(Department of respiratory Medicine,Guangzhou twelfth People's Hospital,Guangzhou 510620,Guangdong Province,China;Department of radiology,Guangzhou twelfth People's Hospital,Guangzhou 510620,Guangdong Province,China)

机构地区：[1]广州市第十二人民医院呼吸内科,广东广州510620 [2]广州市第十二人民医院放射科,广东广州510620

出　　处：《中国CT和MRI杂志》2025年第2期86-88,共3页Chinese Journal of CT and MRI

基　　金：2023年度广东省医学科研基金指令性课题项目(C2023078)。

摘　　要：目的评估肺侵袭性真菌病(IFD)和细菌性肺炎高分辨率CT的比较研究价值。方法回顾分析208例IFD(n=102)或细菌性肺炎(n=106)的CT表现。将肺阴影分为实变型、磨玻璃样阴影(GGO)或结节状,并对比评估。结果83.3%的IFD患者和92.5%的细菌性肺炎患者出现实变。IFD的多灶性非节段性实变(48%)多于细菌性肺炎(22.6%;P<0.05)。细菌性肺炎节段性或亚节段性实变发生率(43.4%)明显高于IFD(7.8%;P<0.01)。GGO和结节在IFD中比细菌性肺炎更常见(分别为60.8%比24.5%和54.9%比15.1%,P均<0.05)。实变合并GGO或结节,或同时合并GGO和结节,IFD多于细菌性肺炎(均P<0.05)。在IFD和细菌性肺炎中,有晕征的结节(n=23)分别占22.5%和3.8%。合并RHS的结节仅见于IFD,空洞结节在IFD和细菌性肺炎中的出现率分别为11.8%和1.9%。结论实变+GGO+结节或实变+结节是诊断IFD的有效方法。Objective To evaluate the comparative value of high-resolution CT in invasive fungal disease of the lung(IFD)and bacterial pneumonia.Methods CT findings of 208 cases with IFD(n=102)or bacterial pneumonia(n=106)were retrospectively analyzed.Pulmonary shadows were classified as solid,ground glass shadows(GGO),or nodules,and the presence of ground glass halos,anti-halos signs(RHS),and voids(crescent or non-crescent)around the nodules were recorded.Results 83.3%of IFD patients and 92.5%of bacterial pneumonia patients had realistic changes.Multifocal nonsegmental consolidation was more common in IFD(48%)than bacterial pneumonia(22.6%;P<0.05).The incidence of segmental or subsegmental consolidation in bacterial pneumonia(43.4%)was significantly higher than that of IFD(7.8%;P<0.01).GGO and nodules were more common in IFD than bacterial pneumonia(60.8%vs.24.5%and 54.9%vs.15.1%,respectively,P<0.05).Consolidation with GGO or nodule,or both,had more IFD than bacterial pneumonia(all P<0.05).In IFD and bacterial pneumonia,nodules with halo sign(n=23)accounted for 22.5%and 3.8%,respectively.Nodules associated with RHS were only found in IFD.The incidence of caudal nodules in IFD and bacterial pneumonia was 11.8%and 1.9%,respectively.Conclusion Consolidation+GGO+nodule or consolidation+nodule is an effective method for the diagnosis of IFD.

关 键 词：肺侵袭性真菌病 细菌性肺炎 高分辨率CT 

分 类 号：R563.1[医药卫生—呼吸系统]