肺曲菌病的X线表现与病理对照分析

The contrast of X ray manifestation and pathology of pulmonary aspergillosis.

目的对照病理改变探索肺曲菌病Ｘ线影像形成的机制。方法对５１例肺曲菌病的Ｘ线所见，与２８例病理标本对照分析。结果过敏性及侵袭性各１例，寄生性４９例。Ｘ线影象在寄生性中最具特点，在基础性病变形成的空洞／空腔中有大小不等，形态不一的菌块，形成游离于空洞内的球体，洞内球周为具有特征的半月征及晕征。是寄生性肺曲菌病的主要诊断依据。结论１．肺结核是寄生性肺曲菌病的最多见的基础病。２．

Objective To study the pathogenesis of X ray imagings in contrast with pathologic changes in pulmonary aspergillosis.Methods The X ray findings of 51 cases with pulmonary aspergillosis and 28 cases pathologic results among them were retrospectively studied.Results The major X ray findings of pulmonary aspergillosis were as followes(1)parasitic pulmonary aspergillosis:there was aspergilloma shaped like a ball in the cavity of the underlying disease(38 cases).(2)allergic pulmonary aspergillosis:there was the underlying disease in one lobe in lung,and in another lobe there was bronchial mucus cast(“finger cover sign”).(3)invasive pulmonary aspergillosis:there were central necrosis in them.It was original pulmonary aspergillosis and there was no underlying disease in lung.Bronchial arteriography(BAG)demonstrated that there were common hyperplasias of bronchial arterial trunk and its branches(“blushs”),bronchial pulmonary arterial anastomoses(“shunts”),blooding focuses in the pulmonary parenchymal and bronchial arterial aneurysms,and so on. Conclusion (1)Radiographic features of aspergilloma are the important diagnostic bases in parasitic pulmonary aspergillosis.(2)Pulmonary tuberculosis can compicated with aspergillosis,but these tuberculoses were all cured and stable,which suggested that the treatment of pulmonary aspergillesis was the key.(3)Bronchial arteriography demonstrated that the pathologic basis of hemoptysis for pulmonary aspergillosis was the damage of bronchial artery.If embolization for hemoptysis is no effect,sugical resection should be considered.