肺部真菌感染的CT影像学诊断分析

Value of CT imaging in diagnosis of pulmonary fungal infections

目的探讨CT影像学应用于临床诊断和治疗肺部真菌感染的价值,给临床诊断和治疗肺部真菌感染提供理论依据。方法选取2011年5月-2015年4月医院接受治疗肺部真菌感染患者96例作为研究对象,回顾性分析真菌感染患者的CT影像学结果和病原菌的分布构成,并与X线检查结果进行对比分析。结果 96例肺部真菌感染患者CT影像学显示,肺部真菌感染类型:曲球菌型31例占32.29%、实变型17例占17.71%、结节型8例占8.33%、弥漫型40例占41.67%;CT影像学检测结果呈阳性的患者81例,阳性率为84.38%,X射线检查呈阳性的患者56例,阳性率为58.33%,两种检查方法比较,差异有统计学意义(P<0.05);96例肺部真菌感染患者真菌培养阳性96例,阳性率为100.00%,其中曲霉菌属39株占40.62%、白色假丝酵母菌34株占35.42%、光滑假丝酵母菌12株占12.50%、热带假丝酵母菌8株占8.33%、其他3株占3.13%。结论 CT影像学结果结合患者的基本病情,能初步诊断肺部真菌感染,在临床治疗有较高的应用价值,值得推广应用。

OBJECTIVE To explore the value of CT imaging in clinical diagnosis and treatment of pulmonary fungal infections so as to provide theoretical basis for clinical diagnosis and treatment of the pulmonary fungal infections.METHODS A total of 96 patients with pulmonary fungal infections who were treated in the hospital from May 2011 to Apr 2015 were recruited as the study objects.The results of the CT imaging and constituent ratios of pathogens isolated from the patients with fungal infections were retrospectively analyzed and were compared with the results of X-ray examination.RESULTS The CT imaging of the 96 patients with pulmonary fungal infections showed that31（32.29%）had Aspergillomatype infection,17（17.71%）had real variant infection,8（8.33%）had nodular type infection,and 40（41.67%）had diffuse type infection.Totally 81 patients showed positive for the CT imaging examination,with the positive rate 84.38%;totally 56 patients showed positive for the X-ray examination,with the positive rate 58.33%,and there was significant difference between the two examination methods（P〈0.05）.Of the 96 patients with pulmonary fungal infections,96 showed positive for the fungal culture,with the positive rate 100.00%;there were 39（40.62%）strains of Aspergillus,34（35.42%）strains of Candida albicans,12（12.50%）strains of Candida glabrata,8（8.33%）strains of Candida tropicalis,and 3（3.13%）strains of other species.CONCLUSIONThe CT imaging combined with illness condition and clinical symptoms has great value in early diagnosis of the pulmonary fungal infections and improvement of the cure rate.