侵袭性肺曲霉菌病的影像学诊断

Imaging diagnosis of invasive pulmonary aspergillosis

目的探讨侵袭性肺曲霉菌病(IPA)的X线及CT表现,提高对该病的认识。方法回顾性分析经病原学或病理组织学证实的IPA6例(男4例、女2例)。基础病变包括肾移植术后5例及白血病1例,全部病例均行胸部X线及CT检查。结果4例表现为多发斑片状及片状影,其中2例伴空洞形成,1例表现为多发小结节影,1例表现为单发团块状影。影像诊断肺霉菌病3例,误诊3例。结论IPA的影像学表现无特异性,影像学检查结合临床资料对本病的诊断有一定价值。

Objective To study the X-ray and CT findings of invasive pulmonary aspergillosis （IPA） and to elevate the recognition of this disease. Methods Imaging data of 6 patients with IPA which was confirmed by etiology or histopathology were retrospectively analyzed. The basic lesions of IPA were secondary to renal transplantation （n=5 ） and leukemia （n=1 ） . All patients underwent chest X-ray plain film examinations and CT scans. Results On chest X-ray and CT images, intrapulmonary multiple mottling shadows and patchy ghadows were found in 4 cases in whom 2 cases were complicated with cavity formation, intrapulmonary multiple nodular shadows and single mass shadow in 1 each. Based on imaging findings, 3 cases were correctly diagnosed while other 3 cases were misdiagnosed. Conclusion Imaging findings of IPA are not specific but the integration of imaging and clinical data has important value to diagnose this disease.