艾滋病合并鸟．胞内分枝杆菌感染的胸部影像表现

Thoracic imaging manifestations of mycobacterium avium-intracellulare complex infection in patients with acquired immunodeficiency syndrome

目的探讨艾滋病（AIDS）合并鸟．胞内分枝杆菌（MAC）感染的胸部影像表现及特征。方法回顾性分析非结核分枝杆菌培养阳性，经菌种鉴定为MAC的AIDS患者31例，其影像表现及临床资料。31例患者中30例行胸部CT及X线检查，1例仅行胸部x线检查。结果31例AIDS合并MAC感染患者中，3例肺部未见病变，28例为MAC肺部感染。AIDS合并MAC肺部感染的影像表现类似肺结核改变，常见的CT征象有斑片影21例，其中大片实变3例；支气管扩张18例，结节18例，双肺弥漫粟粒10例，空洞10例，胸腔积液10例，纵隔淋巴结肿大15例，以中度肿大为主，7例肺门淋巴结大，双肺门多见。结论AIDS合并MAC感染的胸部影像表现多样、不典型，以斑片影、小结节及支气管扩张多见。

Objective To study the chest imaging manifestations of mycobacterium avium-intracellulare complex （MAC） infection in patients with acquired immunodeficiency syndrome（AIDS）. Methods Thirty-one cases of proven AIDS and MAC infection were included in the study. Imaging findings and clinical data of the patients were retrospectively analyzed. Results All 31 patients underwent chest X-ray and/or chest CT examination, three patients were normal, 28 patients showed findings of lung infection. The chest CT imaging findings of MAC lung infection in AIDS patients were similar with pulmonary TB, including air space consolidation （21 cases） with three cases of large consolidation, bronchiectasis （18 cases）, nodules （18 cases）, miliary nodules （10 cases）, cavities （10 cases）, pleural effusion （10 cases）, predominantly moderately enlarged mediastinal lymph nodes （15 cases）, and enlarged hilus lymph nodes （7 cases）. Conclusions The imaging manifestations of MAC infection in AIDS patients were varied and atypical. Air space consolidation,small nodules and bronchiectasis were the main CT manifestations of MAC pulmonary disease.