爱滋病人卡氏肺囊虫肺炎的影像学诊断

Imaging Diagnosis of Pneumocystis Carinii Pneumonia in AIDS

目的 分析爱滋病 (AIDS)患者卡氏肺囊虫肺炎 (pneumocystiscariniipneumonia ,PCP)的影像学表现特点。材料与方法 搜集 33例经病理证实的PCP患者 ,全部病例均行胸部X线检查 ,10例进行CT扫描检查。血液HIV抗体检查均为阳性。结果 双肺弥漫性渗出性病变分布于肺门周围 ,而肺尖及周围肺野清晰 ,病灶由肺门向周围肺野发展且呈明显的融合趋势 ,为典型的影像学表现。少见的表现有大叶实变、肺门淋巴结增大、肺囊性病变、胸腔积液及肺不张等。临床症状主要为干咳、胸痛、气促和发热而体征轻微。结论 典型的胸部影像学表现加上症状明显而体征轻微的临床表现 ,排除了其他原因导致的免疫缺乏性疾病外 ,应要求患者进行血液HIV抗体检查。

Objective To characterize the Xray and CT findings of pneumocystis carinii pneumonia (PCP) in AIDS.Materials and Methods Diagnostic findings, including plain chest film (n=33) and CT scan (n=10), in 33 positive HIV cases with pathologicallyproved PCP were analyzed.Results The typical manifestations of PCP was bilateral diffuse infiltration distributing in perihilar regions and presenting as radiate shadows from hila to lung fields. Unusual findings included lobar consolidation, hilar adenopathy, cystic lesions, pleural effusion and atelectasis, etc. Clinical symptoms included nonproductive cough, dyspnea, chest pain and fever, while physical signs were very mild.Conclusion HIV test is necessary in patients with typical imaging and clinical manifestations when other immunodeficient diseases except AIDS can be excluded. And if HIV is positive, the diagnosis of PCP in AIDS can be confirmed.