过敏性支气管肺曲菌病的临床分析及HRCT表现

Clinical Analysis and HRCT Characteristics of Allergic Brochopulmonary Aspergillosis

目的提高对过敏性支气管肺曲霉菌病(ABPA)的认识和诊断准确率。方法回顾性分析9例经临床和实验室诊断的ABPA的CT表现。结果 9例患者均见中心性支气管扩张,4例为单侧,5例为双侧;上叶支气管受累11处,下叶支气管受累5处。8处扩张支气管呈囊状、串珠状改变,12处扩张支气管呈牙膏样、指套样改变,内见粘液栓充填,其中9处粘液栓呈高密度。扩张支气管周围见马赛克灌注、小叶中心结节、树芽征;2例见肺不张。结论中心性支气管腔扩张并周边支气管变细为ABPA相对特征性的HRCT表现,结合实验室化验检查可确定诊断。

Objective To improve the diagnostic accuracy of allergic brochopulmonary aspergillosis（ABPA） on CT and clinical.Methods The CT findings of 9 patients with ABPA were retrospectively analyzed.Results The HRCT depicted central bronchiectasis in all patients,unilateral lung of 4 cases and bilateral lung of 5 cases.involving 11 superior lober and 5 lower lober.Saccular and string-of-beads bronchiectasis were seen in 8 cases.The mucoid impaction of the dilated bronchial treewee seen in 12 cases,presenting as gloved-finger and toothpaste appearance,while some mucus were slightly hyperdensen of 9 cases.Conclusion Central bronchiectasis with peripheral tapering of bronchi on HRCT is believed to be a character for the diagnosis of ABPA.It can make a definite diagnosis with laboratory tests.