恶性肿瘤化疗后继发侵袭性肺曲霉菌病的CT表现

A study on the appearance of invasive pulmonary aspergillosis secondary to post-chemotherapy of malignant tumors on CT images

目的分析恶性肿瘤化疗后继发侵袭性肺曲霉菌病的CT表现,提高对本病的诊断准确性。方法回顾性分析64例化疗后发生肺部侵袭性肺曲霉菌病的恶性肿瘤患者的胸部CT表现,观察肺及肺外病变影像特征。结果 64例均为肺部多发不规则模糊实变影,其中单肺18.75﹪(12/64),双肺81.25﹪(52/64);支气管充气征81.25﹪(52/64),晕征39.06﹪(25/64),空气新月征15.63﹪(10/64);胸腔积液45.31﹪(29/64),胸膜增厚26.56﹪(17/64),肺门淋巴结肿大32.81﹪(21/64),纵隔淋巴结肿大18.75﹪(12/64),心包积液4.69﹪(3/64)。结论肺部曲霉菌感染的CT表现复杂,结合患者临床资料综合分析,能够为恶性肿瘤化疗后继发IPA临床治疗诊断提供依据。

Objective To investigate the the appearance of invasive pulmornary aspergillosis secondary to post-chemotherapy of malignant tumors on CT images, and to improve the diagnostic accuracy. Methods The CT feathers of chest in 64 patients, including pulmonary and extrapulmonary lesions , were retrospectively analyzed. Result Muliple lesions with irregular and fuzzy consolidation were observed in all cases, including unilater lung 18.75 ﹪（12/64） , bilater lung 81.25﹪（52/64） , air bronchogram 81.25﹪（52/64） , halo sign 39.06﹪（25/64） , air-crescent sign 15.63 ﹪（10/64） , pleural effusion 45.31﹪（29/64） , pleural thickness 26.56﹪（17/64） , hilar lymph node enlargement 32.81 ﹪（21/64）, mediastinal lymph node enlargement 18.75 ﹪（12/64）, pericardial effusion 4.69 ﹪（3/64）. Conclusion The appearance of invasive pulmornary aspergillosis on CT images were complex and diverse, and the clinical data should be integrated, to provide a basis for diagnose of IPA secondary to post-chemotherapy of malignant tumors.