变应性支气管肺曲菌病的X线和CT表现

Chest radiographic and CT findings in allergic bronchopulmonary aspergillosis

目的:探讨变应性支气管肺曲菌病(ABPA)患者胸部X线和CT表现。方法:回顾性分析10例经临床确诊的ABPA患者的胸部X线及CT资料。结果:胸部X线表现多种多样,同一个病例可有多种表现:片状及结节状游走性浸润影3例,结节状类似肉芽肿性阴影2例,局限性肺不张2例,支气管柱状或囊状扩张6例,"牙膏样"或树枝样阴影3例。胸部CT表现亦多种多样:中央型支气管扩张并支气管内粘液栓形成6例,其中2例支气管扩张表现为平行的轨道状,1例表象为静脉曲张状,4例支气管内粘液栓表现为结节状高密度影。4例有肺段或肺叶的实变,2例有部分肺不张,2例有肿块影。10例患者上叶均有病灶,其中5例位于右肺上叶。结论:ABPA影像学表现为一过性肺浸润和中心性支气管扩张为主要特点,结合临床表现及实验室检查能提高本病的诊断准确性。

Objective：To describe and analyze the chest radiolographic and CT features in patients with allergic bronchopulmonary aspergillosis （ABPA）. Methods： Imaging data of chest radiography and CT in 10 patients with ABPA were retrospectively analyzed. Results：On chest X-ray film of ABPA, there were aften various changes：patchy and nodular migra tory infiltration （n=3）, nodular granulomatous shadows （ n= 2）, focal atelectasis （n= 2）, cylindric or saccular bronchiecta- sis （n=6） and foothpaste-like or tree-like shadows （n=3）. On CT imaging, following changes could be observed： central bronchictasis with bronchial mucous plug for mation （ n = 6）, segmental or lobar consolidation （ n= 4 ）, partial atelectasis （n=2） and tumoral shadows （n=2）. The upper lobe was indolved in all ten patients, and in five of the ten patients the right upper lobe was involved. Conclusion：ABPA has some cbardeteristic imaging features. The was features were transient pulmonary infiltration and ceutral bronchiectasis, combined with clinical manifestation and laboratory findings the diagnostic aceuracy can be improved.