肺隐球菌病的螺旋CT诊断

Spiral CT diagnosis of pulmonary cryptococcosis

目的探讨肺隐球菌病的螺旋CT表现,以提高其诊断准确率。方法回顾性分析36例经病理证实的肺隐球菌病的临床及CT资料,分析其特征性表现。结果肺隐球菌病临床症状主要表现为咳嗽及胸痛,无症状8例。CT上根据病灶形态分三型为:①结节、团块或片状影27例,其中单发病灶(结节或团块影)6例,多发病灶(包括多发结节、结节并团块或片状影)21例;②浸润实变影6例;③弥漫混合型3例。36例病灶中位于两肺下叶21例(58.3%),位于肺外带及胸膜下区22例(61.1%),伴有空洞11例(30.6%),晕征7例(19.4%)。结论肺隐球菌病CT表现多样,以结节、团块或片状型多见;病灶多分布于肺外周,可伴空洞、晕征,结合临床表现有助于肺隐球菌病的诊断。

Objective To determine the diagnostic CT features of pulmonary cryptococcosis （PC）. Methods The clinical records and spiral CT scans of 36 patients with histologically confirmed PC were retrospectively analyzed. Results The clinical presentation in 28 patients was cough and chest pain. Eight patients were asymptomatic. CT showed solitary pulmonary nodule/mass （n=6）, multiple nodules, masses or patchy opacity （n=21）, consolidation （n=6）, or diffuse mixed nodule/mass and opacity （n=3）. The lesions were located in both lower lobes （n=21, 58.3%）, in the lung periphery or subpleural region （n=22, 61.1%）. Cavitation （n=1 1, 30.6%） and halo sign （n=7, 19.4%） were also evident in half of the patients. Conclusion CT features of PC are variable with most commonly pulmonary nodule, mass or patchy opacity. Peripheral location of these lung lesions with cavitation and halo sign is characteristic and can aid in the diagnosis of PC.