AIDS合并肺隐球菌病胸部CT的特征表现

Nodules and Nodular Opacities with Cavitation:CT Features of Pulmonary Cryptococcosis in AIDS Patients

目的探讨AIDS并发肺隐球菌病（PC）肺部HRCT表现。方法回顾性分析2013年1月至2015年11月间确诊的69例AIDS合并PC患者胸部HRCT及增强CT征象。结果 69例患者肺内共144个病灶,其中实性结节49个,空洞结节75个,斑片絮状影12处,实变8处。实性结节及空洞结节均以肺野中外带为主,多为多发,结节边缘多清晰,多数病灶伴晕征,周围多无卫星病灶。空洞结节壁薄,内壁多不光滑,可见线状分隔、结节悬挂征。2例以大范围实变为主者,经证实为合并有两种以上病原菌感染。增强扫描实性结节以伴强化为主,空洞结节壁多见轻度强化。治疗后病变缩小,部分空洞结节缩小并转变为实性结节。结论 AIDS人群出现肺部多发薄壁空洞结节、实性结节伴晕征,且无卫星病灶时,需考虑到PC可能。

Objective To illustrate the CT findings of pulmonary eryptoeoeeosis in AIDS patients. Methods 69 AIDS patients with pulmonary eryptoeoccosis between January 2013 and November 2015 were retrospectively studied. CT findings on HRCT and enhanced CT were described. Results 144 lesions were detected in 69 patients. Among them,there were 49 lesions which presented as solid nodules ,75 as nodular opacity with cavitation, 12 as patchy effusion, and 8 as consolidation. The majority of solid nodules and nodular opacities with cavitation distributed in the medial and lateral lung field, with clear boundary and halo sign around. Few satellite lesions were detected in the peripheral part of the nodules and nodular opacities. 2 of the patients with consolidation proved to be infeeted by multi-organisms. Enhancement was displayed in most of the solid nodules and in cavity walls. Follow-up images showed that lesions shrink, and some of nodular opacities with cavitation turn into small nodules after anti-eryptocoecus treatment. Conclusion Nodules and nodular opacities with cavitation,accompanied with halo sign and without satellite lesions, are profound features of pulmonary eryptococeosis in AIDS patients.