老年空洞型肺结核合并肺曲霉菌病的CT征象分析

Analysis of CT signs of cavitary pulmonary tuberculosis with pulmonary aspergillosis in the eld

目的:探讨老年空洞型肺结核合并肺曲霉菌病(Pulmonary aspergillosis,PA)的CT影像特征。方法:回顾性分析经病理及实验室检查确诊的50例空洞型肺结核合并PA患者,根据年龄段分为老年组(≥60岁)和中青年组(18~<60岁),总结分析两组患者各自发病规律,同时对两组患者的临床资料及影像征象进行对照分析。结果:35例老年组患者中,出现新月征35例(100.00%),单发空洞结节32例(91.43%),PA内钙化26例(74.29%),厚壁空洞26例(74.29%)、PA边缘不光滑26例(74.29%),PA菌丝桥24例(68.57%),不规则空洞24例(68.57%),右肺上叶空洞22例(62.86%),左肺上叶空洞8例(22.86%)。老年组与中青年组比较,空洞最大径、空洞位置、空洞形态、PA内钙化均P<0.05,差异有统计学意义。结论:老年空洞型肺结核合并PA多呈不规则厚壁空洞,新月征、PA内钙化及菌丝桥是其典型征象。与中青年组患者比较,老年组患者空洞常位于胸膜下,呈较大、不规则空洞,PA内钙化明显高发。

Objective:To explore the CT features of cavitary pulmonary tuberculosis with pulmonary aspergillosis(PA)in the eld.Methods:Fifty patients with cavitary pulmonary tuberculosis with PA diagnosed by pathology and laboratory examination were analyzed retrospectively.According to the age group,the patients were divided into the eld group(age≥60 years old)and the young and middle-aged group(age 18~<60 years old).To summarize and analyze the pathogenesis of the two groups,The clinical data and imaging features of the two groups were analyzed.Results:Among the 35 eld patients,35(100.00%)had crescent sign,32(91.43%)had single cavitary nodule,26(74.29%)had calcification in PA,26(74.29%)had thick walled cavities,26(74.29%)had unsmooth margins in PA,24(68.57%)had a hyphal bridge in PA,24(68.57%)had irregular cavities,22(62.86%)had a right upper lobe cavities,and 8(22.86%)had a left upper lobe cavities.Compared with the young and middle-aged group,the largest diameter,location,shape and calcification in PA in the eld group were all P<0.05,with statistical significance.Conclusion:Most of the cavitary pulmonary tuberculosis with PA in the eld presented irregular thick walled cavity,crescent sign,calcification in PA and hyphal bridge were typical signs.Compared with the young and middle-aged patients,the eld patients usually presented with subpleura location,large and irregular cavities,and the calcification in PA.