变应性支气管肺曲霉菌病的HRCT表现

The HRCT features of allergic bronchopulmonary aspergillosis

目的评价变应性支气管肺曲霉菌病的HRCT表现。方法回顾性分析7例变应性支气管肺曲霉菌病患者的肺部高分辨率CT图像。结果7例(100%)患者均可见到中心性支气管扩张,共累及28/35个(80%)肺叶和70/126个(55%)肺段;7例(100%)扩张支气管腔内均可见粘液嵌塞,呈指套样、牙膏状改变,其中5例(71%)为稍高密度,1例(14%)可见到钙化;4例(57%)可见肺实变;2例(28%)合并肺叶含气不全;3例(42%)合并肺门淋巴结增大。结论长期哮喘的病人如果HRCT上发现中心性支气管扩张,同时管腔内可见稍高密度的粘液嵌塞或高密度钙化,需考虑ABPA的可能。

ObjeCtive To study the HRCT features of Allergic Bronchoputmonary Aspergillosis. Methods Thelung HRCT of 7 cases were all reviewed retrospectively. Results The HRCT depicted central bronchiectasis in 7 cases （100%）, involving 28/35 （80%） lobes and 70/126 （55%） Segments; The mucoid impaction of the dilated bronchial tree wee seen in all 7 cases （100%）, presenting as gloved-finger and toothpaste appearance. while some mucus were slightly hyperdensen of 5 cases and were high-attenuation calcification of lease; Consolidation were found in 4 cases （57%）;2 cases （28%） complicated with：lobar atelectasis; Hilar lymphadenopathy was seen in 3 cases （42%）. Conclusion The diagnosis of ABPA should be considered in a patient with long-standing asthma whose HRCT demonstrates central bronchiectasis with slightly hyperdense mucoid impaction or high-attenuation calcification.