肺曲菌病的多层螺旋CT诊断价值

The Value of MSCT in Diagnosis of Pulmonary Aspergillosis

目的析肺曲菌病的MSCT表现,提高对肺曲菌病的认识和诊断能力。方法对20例经病理和治疗随访证实的肺曲菌病进行回顾性分析。结果 20例中13例为曲菌球,7例为侵袭性肺曲菌病。双肺多发4例,右肺9例,左肺7例。CT表现为13例曲菌球均表现为空洞性结节,10例呈新月征,空洞壁厚薄不均,伴周围条索影。7例侵袭性肺曲菌病中,表现为不规则斑片、斑块浸润影或磨玻璃影4例,伴有节段性实变2例;表现为结节影和楔形实变影3例,周边有晕圈征。结论肺曲菌病的影像学表现多种多样,认识其在不同时期具有的相应某些特征性表现,有利于临床早期正确诊断并进行治疗。

Objective To improve the capability of diagnosis of pulmonary aspergillosis. Methods Twenty cases of pulmonary aspergillosis confirmed by pathology or therapeutic following-up were retrospectively summarized and analyzed. Results Apergilloma was found in 13 cases, invasive pulmonary aspergillosis in 7 cases. Twenty cases were respectively located at the right lung （n=9cases）,left lung （n=7cases） and both lung（n=4 cases）.The appearances of the pulmonary aspergillosis were as following： 13 cases showed a hollow lesion with the longest dimention about 10mm-40mm, of which thin wall cavity accompanying a nodule with the ＂meniscus sign＂was seen in 10 cases .The anomalous spotted or patchy opacification, mass like the mottling infiltration shadow and the ground glass shadow were seen in 4 cases, of which 2 cases accompaning by the segmental consolidation. The pulmonary nodular and subpleural wedge-shaped consolidation with the ＂halo sign＂ were seen in 3 cases. Conclusion Various imaging findings in pulmonary aspergillosis, and some special appearances at different phases are valuable to make earlier diagnosis and therapy .