军团菌肺炎的影像学表现及其诊断价值

Imaging appearances and its diagnostic value in Legionella pneumonia

目的探讨军团菌性肺炎的影像学表现及其影像诊断价值,提高对本病的认识。方法回顾分析经临床综合诊断35例军团菌性肺炎的临床及系列影像资料,并总结其影像学特征。结果军团菌性肺炎的主要影像学表现为:多形态病变31例;多叶多段病变25例;胸腔积液10例;肺脓肿6例;临床症状与影像学表现不一致21例;影像学改变吸收缓慢(时间大于2周者)30例;伴有纤维索条、网状影或蜂窝影者28例。因此,军团菌性肺炎的征象主要以多形态病变、多叶多段病变以及多伴有纤维索条、网状影或蜂窝影等纤维化为特征;而其动态影像学主要是以影像学改变吸收缓慢和影像学改变与临床症状不一致为特征。结论军团菌性肺炎的影像学表现虽较复杂,但也有一定特征性,结合病史、体征及实验室检查可提示诊断。

Objective To study the imaging appearances and its diagnostic value in Legionella pneumonia （LP）, and to improve the understanding ability of this disease. Methods The clinical and serial imaging materials of 35 cases LP which were proved by clinical comprehensive diagnosis were retrospectively analyzed, and its imaging features were summarized. Results There were 31 cases with polymorphic shadows in 35 patients. Twenty-five patients＂ shadows were distributed multiple pulmonary segments and multiple lobes of lung. Ten cases had hydrothoraxes. Six patients had pulmonary abscesses. Twenty-eight cases had pulmonary interstitial fibrosis, such as honeycomb lung, reticular and cordal shadows. The imaging changes of 21 cases＂ LP were not in consonance with the clinical manifestation. Thirty cases＂ imaging changes were slowly absorbed. The features of LP＇s imaging morphology were polymorphic changes, multiple pulmonary segments and multiple lobes, and pulmonary interstitial fibrosis. The features of dynamic imaging were that the imaging changes were not in consonance with the clinical manifestation and imaging findings were slowly absorbed. Conclusion The imaging findings of LP are complex. But the LP possess relative imaging feature. In combination with medical history, physical sign and laboratory examination, the possibility of LP diagnosis can be suggested.