军团菌肺炎的胸部CT表现(附14例分析)

Legionnaires' Disease: CT Findings in 14 Cases

目的：了解军团菌肺炎的ＣＴ表现特点及ＣＴ能否提供较平片更多有利于本病诊断及治疗的信息。材料与方法：收治１４例经临床及血清学证实的军团菌肺炎患者，分析其胸部ＣＴ表现特点，并与平片进行对比分析。结果：ＣＴ扫描示病变呈多叶段受累者１１例。大片及斑片状阴影为最常见的表现，见于本组１０例患者；空洞病变３例，其中１例似金葡菌肺炎表现，余１例表现双肺弥漫毛玻璃样密度及索条影。在本组病例中，１０例伴胸腔积液及胸膜肥厚；心包积液与纵隔淋巴结肿大各１例。胸部ＣＴ显示病变较平片更多，更清晰。结论：军团菌肺炎ＣＴ表现呈多样性，以多叶段受累为特点，常伴胸膜病变。胸部ＣＴ较平片敏感，为本病的诊断及疗效观察提供可靠征象。

Objective: The purpose of this study was to demonstrate CT features of Legionnaires' disease.Materials and Methods:Fourteen patients were hospitalized with Legionnaires' disease, the diagnosis was established on clinical findings and serologic test. All CT scans were reviewed and compared with their chest plain films.Results:CT scans showed lesions involving multiple bobes in 11 patients. Patchy consolidation was the most common pattern which present in 10 cases; cavitary lesions without air fluid level in 3, one of them was similar to staphylococcal pneumonia in appearance. The last one showed bilateral diffused groundglass attenuation with liner opacities. In all cases, 10 patients had pleural effusion and pleural thickening; pericardial effusion and mediastinal lymphadenopathy in one patient, respectively. Chest CT scans showed much more and clear lesions than plain films.Conclusion: CT findings in Legionnaires' disease are variable, with a feature of multiple lobe involvement, usually combined with pleural lesions. Chest CT scan is more sensitive than plain film and could render reliable signs for the diagnosis and treatment of Legionnaires' disease.