流感季节金黄色葡萄球菌肺炎CT表现

CT FINDINGS OF STAPHYLOCOCCUS AUREUS PNEUMONIA DURING INFLUENZA SEASON

目的探讨流感季节金黄色葡萄球菌肺炎的CT表现。方法回顾性分析经临床证实为金黄色葡萄球菌肺炎的57例病人的多次随访CT表现。结果 57例病人首次CT检查均呈沿支气管分布的斑片、结节影的支气管肺炎表现,18例伴片状磨玻璃影,11例并发胸腔积液,52例病人累及双肺。1周内CT随访,50例病变斑片、结节影融合成大片实变影,其中13例出现空气支气管征,17例出现肺气囊,4例出现空洞,15例并发胸腔积液。2~3周复查CT,45例结节、斑片影及大片实变影吸收好转,12例病变范围较前增大;17例肺气囊病人中,5例肺气囊消失,11例出现新肺气囊,1例较前变化不大;15例出现空洞,27例并发胸腔积液,4例并发气胸。4~5周复查CT,52例病变吸收好转,仍存在肺气囊10例,胸腔积液5例;进展或复发5例。结论 流感季节金黄色葡萄球菌肺炎CT表现复杂多样、变化迅速,但有一定的演变规律,及时行CT复查对该病诊断有重要价值。

ObjectiveTo investigate the CT findings of Staphylococcus aureus pneumonia in influenza season.Me-thodsA retrospective analysis was performed for the multiple follow-up CT findings of 57 patients with clinically confirmed Staphylococcus aureus pneumonia.ResultsThe initial CT examination of all 57 patients showed the manifestations of bronchial pneumonia with patchy and nodular opacities distributed along the bronchia;18 patients had patchy ground-glass opacities,11 had pleural effusion,and 52 had the involvement of both lungs.The follow-up CT scan within 1 week showed that the patchy and nodular opacities merged to form a large patch of consolidation in 50 patients,among whom 13 had air bronchogram,17 had pulmonary air sacs,4 had cavities,and 15 had pleural effusion.The follow-up CT scan performed at 2-3 weeks showed that 45 patients achieved the absorption and improvement of patchy and nodular opacities and the large patch of consolidation,and 12 had an increase in the extent of lesions;among the 17 patients with pulmonary air sacs,5 achieved the disappearance of pulmonary air sacs,11 had new pulmonary air sacs,and 1 had no significant change;15 patients had cavities,27 had pleural effusion,and 4 had pneumothorax.The follow-up CT scan performed at 4-5 weeks showed that 52 patients achieved the absorption and improvement of lesions;10 patients still had pulmonary air sacs,5 had pleural effusion,and 5 experienced progression or recurrence.Conclusion Staphylococcus aureus pneumonia in influenza season has complex CT findings with rapid changes and certain rules of evolution,and timely CT ree-xamination has an important value in the diagnosis of Staphylococcus aureus pneumonia.