肺曲菌病的CT影像诊断

CT Diagnosis of Pulmonary Aspergillosis

目的:探讨肺曲菌病的CT表现和诊断价值。方法:本组病例6例,分别经手术病理和治疗随访证实,男性3例,女性3例,年龄32~60岁。5例有轻重不一的发热、咳嗽、胸痛、铁锈色痰或血丝痰,1例无任何症状和体征。采用SIEMENS SENSATION 16层螺旋CT,6例均行CT平扫。肺窗:WW1500HU,WC-500HU;纵隔窗:WW400HU,WC40HU。4例加行多方位图像重建(MPR)。结果:病灶位于右肺2例,左肺4例。2例表现为孤立性实质性结节,直径10 mm^37 mm,类圆形,边缘可见棘突及"晕影"。4例为空洞性结节,直径15 mm^87 mm,其中2例具有"新月"征,2例具有"滚珠"征。结论:肺曲菌病早期影像表现缺乏特征性,当病变局限形成曲菌球,尤其具备"新月征"和"滚珠征"时,才是CT诊断的可靠依据。

Objective：To evaluate the CT appearance and diagnosis of the aspergillosis.Methods：SIX patients with aspergillosis confirmed by operative pathology or therapeutic following-up were retrospectively analyzed.The patients with age from32to 60 years old.Results：The seven lesions with the longest dimention from 10 mm^37 mm were respectively located at the right lung（n=2 cases） and left lung（n=4 cases）.The appearances of the pulmonary aspergillosis were followed as a solitary pulmonary nodule with the ＂hole sign＂（n=2 cases） and a hollow lesion with the ＂meniscus sign＂ or ＂rolling ball sign＂（n=2 cases）.Conclusions：There is no diagnostic specificity of the imaging appearances in early phase of the aspergillosis.The aspergilloma is the special CT signs while with the？ ＂meniscus sign＂ or ＂rolling ball sign＂.