陈旧性肺结核继发空洞性肺曲霉菌病CT分析

CT analysis of Cavitary Pulmonary Aspergillosis second to Obsolete Pulmonary Tuberculosis

目的探讨继发于陈旧性肺结核的空洞性肺曲霉菌病的CT诊断价值。方法回顾性分析98例继发于陈旧性肺结核的空洞性肺曲霉菌病患者胸部CT检查资料。观察空洞内曲霉菌的CT表现。结果 98例共104个病灶。1、其中含球病灶43个,非含球病灶61个;两组对比,含球病灶中简单空洞(26个)、钙化(27个)较为多见(P<0.05);非含球病灶中复杂空洞(46个),胸膜增厚(23个),CTA发现病灶血管增粗增多迂曲(12个)较为多见(P<0.05)。2、空洞内曲霉菌CT表现分为典型曲菌球、附壁结节、空洞壁增厚、部分软组织填充、软组织完全填充五类,其中以空洞内见"部分软组织填充征象"最多见,占56.7%(59/104)。结论空洞性肺曲霉菌的CT征象是多种多样的,需结合曲霉菌不同阶段的影像学资料及临床资料综合考虑,才能提高陈旧性肺结核继发空洞性肺曲霉菌病的诊断。

Objective To investigate the CT value in diagnosis of cavitary pulmonary aspergillosis second to obsolete pulmonary tuberculosis. Methods Chest CT data of 98 cases diagnosed as cavitary pulmonary aspergillosis second to obsolete pulmonary tuberculosis were retrospectively analyzed. Results 1 There were 104 lesions in total（43 cavity with aspergilloma and 61 cavity without aspergilloma）. Comparing group cavity with aspergilloma with group cavity without aspergilloma, the characteristics consist of Simple cavity（n=26）,calcification（n=27） were more common in group cavity with aspergilloma（P〈0.05）; and the characteristics consist of complex cavity（n=46）, pleural thickening（n=14） and lesions found increased bronchial arterial blood supply and increase thick and tortuosity in CTA（n=12） were more common in group cavity without aspergilloma（P〈0.05）. 1 The CT signs of aspergillus inside the cavity can be subdivided into five kinds： Typical Aspergillus, Mural nodules, Cavity wall thickening, Partial soft tissue filling, and Totality soft tissue filling, and the ‘Partial soft tissue filling’ is the most commen signs（56.7%）. Conclusion The CT signs of cavitary pulmonary aspergillosis second to obsolete pulmonary tuberculosis are various. To comprehensive consider the image data and clinical data which of aspergillus in different stages could raise the accuracy of diagnosis in cavitary pulmonary aspergillosis second to obsolete pulmonary tuberculosis.