43例肺曲菌病误诊的CT表现

The CT Manifestations of 43 Patients Misdiagnosed Pulmonary Aspergillosis

目的通过分析肺曲菌病的CT表现,减少对肺曲菌病患者的误诊率。方法收集我院2012—2017年经病理和支纤镜证实的53例肺曲菌病患者的临床资料进行回顾性分析;探讨肺曲菌病误诊的CT表现。结果 53例肺曲菌病患者中影像诊断和临床诊断相一致的有10例,而误诊的43例肺曲菌病患者中,影像学误诊为白血病浸润的患者有25例,误诊为淋巴瘤浸润的患者有2例,误诊为肺结核球的有16例,误诊率高达81%。从病灶分布的部位来看,位于双肺的有40例,单侧右肺为8例,左肺为5例。结论肺曲菌病的影像学表现千变万化,不同分类也具有自身特点;因此,要对各类型的肺曲菌病的影像学表现深入了解并掌握,以便临床能够做出诊断和治疗。

Objective We analyzed the CT manifestations of 43 patients misdiagnosed pulmonary aspergillosis in or- der to reduce the misdiagnosis of pulmonary aspergillosis. Methods From 2012 to 2017, the clinical data of fifty - three ea- ses of pulmonary aspergillosis which were eolffirmed by pathological diagnosis or Bronchial fiberseope diagnosis in our hospital were retrospectively smnmarized and analyzed. The CT manifestations of patients＇ misdiagnosed pulmonary aspergillosis were investigated. Results In fifty- three cases of pulmonary aspergillosis patients, the imaging diagnosis and clinical diagnosis were consistent in ten cases, and the another forty -three cases were misdiagnosed, twenty- -five cases were misdiagnosed as leukemia hffiltration, two cases were misdiagnosed as lymphoma infiltration, and sixteen cases were misdiagnosed as pulmona ry tuberculoma. The misdiagnosis rate was 81%. The focus was located in the bilateral lung in forty cases, the focus was lo- cated in the right lung in eight cases, and the focus was located in the left lung in five cases. Conclusion The pulmonary- aspergillosis has various imaging manifestations, and different classification have its own characteristic, so we should know and command the imaging manifestations in different types which are valuable to make earlier diagnosis and therapy.