艾滋病合并卡氏肺孢子菌肺炎的CT影像分析

CT imaging diagnosis of Pneumocystis carinii pneumonia in patients with AIDS

目的探讨艾滋病合并卡氏肺孢子菌肺炎的CT表现。方法搜集15例经病理、病原学检查或试验性抗肺孢子菌治疗证实的卡氏肺孢子菌肺炎患者,临床症状主要为干咳、低氧血症、进行性呼吸困难、胸痛、发热而体征轻微,血液中人类免疫缺陷病毒(HIV)抗体检查均为阳性,分析其胸部CT检查资料。结果卡氏肺孢子菌肺炎的典型CT表现为:(1)双肺对称性、弥漫性分布磨玻璃密度影,提示实质受累,多位于肺门周围或双侧中下肺野,并逐渐向外、向上发展,从而全肺受累;(2)条索、网格及网织结节影:提示间质受累,与磨玻璃密度影分布基本一致。不典型CT表现有肺实变、肺气囊、纵隔或肺门淋巴结肿大、胸腔积液及气胸等。结论艾滋病患者出现上述CT表现及临床症状时,应考虑到合并卡氏肺孢子菌肺炎的可能性。

Objective To study the characteristics of computed tomography （CT ） imaging of Pneumocystis ca-rinii pneumonia（PCP） in patients with acquired immune deficiency syndrome （AIDS） .Methods A total of 15 pa-tients positive with human immunodeficiency virus （HIV） antibody and with definite diagnosis of PCP were enrolled , clinical symptoms of whom included nonproductive cough ,hypoxemia ,dyspnea ,chest pain and fever ,and characteris-tics of CT imaging were analyzed .Results The typical CT manifestations of PCP included bilateral diffuse ground glass opacity which usually located in the perihilar or bilateral middle and lower lung field ,and gradually outward and upward development ,thus the whole lung involvement and cord ,grid and reticulonodular shadow which were distrib-uted with ground glass opacity .Conclusion When patients with AIDS present above clinical symptoms and CT per-formances ,PCP should be considered .