CT在儿童急性淋巴细胞白血病肺部真菌感染风险评估中的应用  

Application of CT in Risk Assessment of Pulmonary Fungal Infection in Children with Acute Lymphoblastic Leukemia

作　　者：卜凡丹 向金峰[1] 白峰岩[1] 张娴[1] 张晗 BU Fandan;XIANG Jinfeng;BAI Fengyan;ZHANG Xian;ZHANG Han(Department of Pediatric Hematology,Nanyang Central Hospital,Nanyang 473000,China)

机构地区：[1]南阳市中心医院儿童血液科,河南南阳473000

出　　处：《临床医学工程》2025年第3期315-317,共3页Clinical Medicine & Engineering

摘　　要：目的 探讨CT在急性淋巴细胞白血病患儿肺部真菌感染风险评估中的应用价值。方法 选取78例急性淋巴细胞白血病患儿,根据支气管肺泡灌洗液的真菌检测结果分为未感染组和感染组。记录肺部真菌感染的主要类型,对比X线、 CT对肺部真菌感染的阳性检出率,分析患儿的CT图像特征。结果 感染组患儿以白色念珠菌、曲霉菌及热带念珠菌为主要感染真菌。CT对肺部真菌感染的阳性检出率为71.05%,高于X线的21.05%(P <0.05)。感染组的CT晕征、空气新月征占比均高于未感染组,肺叶段实变、支气管血管束占比均低于未感染组(P <0.05)。结论 急性淋巴细胞白血病患儿化疗后,肺部真菌感染的CT表现复杂;当CT示多肺段、多叶、多形、多灶病变时,应高度怀疑真菌感染。Objective To explore the application value of CT in risk assessment of pulmonary fungal infection in children with acute lymphoblastic leukemia.Methods 78 children with acute lymphoblastic leukemia were selected and divided into the uninfected group and the infected group based on the fungal detection results of bronchoalveolar lavage fluid.The main types of pulmonary fungal infections were recorded,the positive detection rates for pulmonary fungal infections were compared between of X-ray and CT,and the CT image characteristics of pediatric patients were analyzed.Results The main fungal infections in the infected group were Candida albicans,Aspergillus oryzae,and Candida tropicalis.The positive detection rate of CT for pulmonary fungal infection was 71.05%,higher than 21.05%of X-ray(P<0.05).The proportions of CT halo sign and air crescent sign in the infected group were higher than those in the uninfected group,and the proportions of pulmonary segment consolidation and bronchial vascular bundle were lower than those in the uninfected group(P<0.05).Conclusions The CT manifestations of pulmonary fungal infection in children with acute lymphoblastic leukemia after chemotherapy are complex;When CT shows multiple lung segments,lobes,pleomorphism,and multifocal lesions,fungal infection should be highly suspected.

关 键 词：CT 急性淋巴细胞白血病 肺部真菌感染 风险评估 

分 类 号：R733.705[医药卫生—肿瘤]