HIV阴性卡氏肺囊虫肺炎的影像学表现

Imaging manifestations of pneumocystis carinii pneumonia with HIV(-)

[目的]探讨H IV阴性卡氏肺囊虫肺炎的影学像表现,提高鉴别诊断水平。[方法]收集经病理证实的H IV阴性卡氏肺囊虫肺炎7例,其中肾移植术后患者5例,白血病化疗患者2例,均摄胸部X线片,3例行胸部CT扫描。[结果]7例均表现为双侧对称或不对称病变,1例为两肺均匀性、完全性实变,其内见支气管气像,3例呈网状结节影及斑片状影,部分融合成片状模糊阴影;3例表现为遍布全肺的浓密的云团状阴影,CT示肺内毛玻璃样、片状影以及和正常肺与病变组织交织嵌合构成马赛克图形。[结论]卡氏肺囊虫肺炎的影像表现呈多样性,X线胸片对本病的诊断有重要价值,最终确诊有赖于病理检查。

[Objective]To investigate the imaging manifestations of pneumocystis carinii pneumonia（PCP） with negative HIV.[Methods]Seven cases with pathologically proved PCP were collected.5 cases of patients after renal transplantation,2 cases of leukemia after chemotherapy,chest radiography was performed in all 7 cases,while additional chest CT scanning was done in 3 ones.[Results]On plain chest radiograph,total 7 cases appeared symmetrical or asymmetrical lesions in both lungs.There was complete consolidation with air bronchogram in one case;netlike and nodule shadows with part of them confused as scattered opacity in 3 cases;and dense cluster shadows distributed all fields of both lungs in 3 cases.On CT scans,the lesinos showed signs of multiple ground glass opacification,patchy shadows,or mosaic pattern when the lesion was interwoven with normal lung parenchyma.[Conclusion]PCP may exhibit a variety of imaging manifestation.Plain chest film is of value for the diagnosis of the disease although a definitive diagnosis depend on pathological evidence.