肺曲霉菌病的影像诊断

The imaging diagnosis of pulmonary aspergillosis

目的探讨肺曲霉菌病的影像学表现特征,为肺曲霉菌病的临床诊断提供诊断依据。方法收集我院近10年来有完整影像、细菌学、临床资料,并经手术、病理、细菌学证实的9例肺曲霉菌病例,在此进行回顾性分析。所有病例均行胸片、CT常规平扫及增强扫描,病灶区加5mm层厚、层距CT扫描,进行影像学分析。结果病灶分布右肺5例、左肺3例、两肺1例;病灶呈肿块或结节可单发和多发,可出现"新月征"、"洞中球征"、"晕征"、"空气支气管征"、磨玻璃样密度改变及肺片状低密度阴影。结论肺曲霉菌病有一定特征性影像表现,结合实验室及多手段病理检查,可提高临床及影像肺曲霉菌病诊断正确率,得以及时治疗。

Objective To discuss the imaging characteristics of pulmonary aspergillosis for the clinical diagnosis of this disease. Methods 9 cases of pulmonary aspergillosis in our hospital for about 10 years were retrospectively reviewed. All the cases were confirmed by operation, pathology and bacteriology. The chest X-ray films, the routine and contrast-enhanced CT scanning （with 5mm slice thickness and 5mm spacing） were analyzed. Results Among all the 9 cases, 5 of them located in right lung, 3 of them located in left lung, 1 of them located in both lung simultaneously. The lesions represented as single or multi nodules with crescent sign, ball in cavity sign, halo sign or air bronchogram. The ground-glass opacities or patched low density opacities were seen in some cases. Conclusion Pulmonary aspergillosis have some characteristic imaging signs. Combined with laboratory and other pathological examination, it can be diagnosed correctly and thus an early treatment can be obtained.