AIDS患者巨细胞病毒感染的肺部HRCT表现

CT findings of cytomegalovirus pneumonia in AIDS patients

目的探讨AIDS并发巨细胞病毒（cytomegalovirus，CMV）感染肺部HRCT表现。方法回顾性分析2015年1月-2015年10月间确诊AIDS合并CMV肺炎患者19例，分析胸部HRCT纵隔窗及肺窗征象。结果19例CMV肺炎患者肺内见磨玻璃斑片影者16例，微结节影5例；小叶间隔增厚7例；部分肺实变者6例；支气管扩张者2例；厚壁空洞影1例。肺内病变以多种形态混合多见，不同类型病变分布各有特点。其中，磨玻璃斑片影多对称分布，外周带重或弥漫分布为主，与隐孢子菌肺炎向心性分布不同。随访结果显示肺内病灶完全吸收者较少，15／17患者肺内有病变残留，并形成纤维索条影或间质纤维化。结论CMV肺炎肺部CT表现多样，磨玻璃影分布特点及治疗后病变残留对于诊断有提示价值。

Objective To illustrate the CT findings of cytomegalovirus pneumonia in AIDS patients. Methods Nineteen AIDS patients with cytomegalovirus pneumonia between January 2015 and October 2015 were retrospectively studied. CT findings on mediastina] window and lung window were described. Results Ground glass opacity was seen in 16 patients, micro nodules were present in 5 patients, interlobular septal thickening was seen in 7 patients, pulmonary consolidation was seen in 6 patients, bronehieetasis was present in 2 patients, and thick-walled cavity was seen in 1 patient. Two or more lesions were commonly seen in a patient simultaneously. The distribution of the lesions was varied. Ground glass opacity was most likely to be diffusedly or to be seen in the peripheral part. Conclusion CT findings of cytomegalovirus pneumonia vary in patients with AIDS, however, detailed features are profound in early diagnosis of cytomegalovirus pneumonia.