肺气肿并发肺炎的高分辨率CT表现

FEATURES OF HIGH RESOLUTION CT IMAGING OF EMPHYSEMA COMPLICATED BY PNEUMONIA

目的提高对肺气肿并发肺炎高分辨率CT(HRCT)表现的认识。方法回顾性分析经临床确诊的21例肺气肿并发肺炎和30例单纯肺炎病人的临床资料、CT和HRCT表现,并进行对比分析。结果肺气肿并发肺炎组与单纯肺炎组的临床症状、体征和实验室检查结果差异无显著性,但肺气肿并发肺炎病人中15例吸烟,占71%;单纯肺炎病人中5例吸烟,占17%。21例肺气肿并发肺炎病人的CT和HRCT表现为单发或多发肺实变,实变内伴有假蜂窝征,少见支气管充气征;30例单纯肺炎病人表现为单发的叶段实变,实变内伴有空气支气管征,实变周围伴有腺泡结节和磨玻璃密度影。结论肺气肿并发肺炎与单纯肺炎有不同的HRCT表现,认识这些影像特点对临床诊断和治疗有重要价值。

Objective To improve, the recognition of high-resolution CT （HRCT） imaging features in patients with emphysema complicated by pneumonia. Methods Clinical manifestations and HRCT imaging features of patients with emphysema complicated by pneumonia （group Ⅰ, n=21） and of simple pneumonia （group Ⅱ, n=30） were retrospectively reviewed and corn pared. Results No significanl difference in terms of symptoms, signs, and results of laboratory examination was found between the two groups. Fifteen patients in group Ⅰ were smokers （71%）, five in group Ⅱ（17%）. HRCT features in group Ⅰ included mono /poly-consolidations with pseudo- honeycombing signs, but sign of air bronchogram was rare. While HRCT features in group Ⅱ comprised of single lobar or segmental consolidation with sign of air bronchogram, acinar nodules and ground glass opacity. Conclusion HRCT features of emphysema patients complicated by pneumonia are different from that of simple pneumonia . The recognition of these imaging fcatures is very important in both diagnosis and treatment of the disease.