孤立结节型肺隐球菌病的薄层CT表现

THIN-SECTION COMPUTED TOMOGRAPHY FINDINGS OF SOLITARY NODULAR-TYPE PULMONARY CRYPTOCOCCOSIS

目的探讨孤立结节型肺隐球菌病的薄层CT表现,以提高对其认识和诊断水平。方法回顾性分析经手术病理或穿刺活检证实的42例孤立结节型肺隐球菌病病人的CT特征及临床资料。结果42例病人中,28例病灶位于右肺,14例病灶位于左肺;病灶主要位于肺外带(33例,占78.57%),以直径>10 mm的结节为主(73.81%)。CT伴随征象中,晕征8例(19.05%),血管集束征26例(61.90%),支气管充气征9例(21.43%),毛刺征10例(23.81%);结节形态类圆形27例(64.29%),不规则形15例(35.71%);胸膜凹陷征12例(28.57%)。21例行增强扫描检查,中度强化10例(47.62%),均匀强化13例(81.25%)。结论孤立结节型肺隐球菌病薄层CT具有一定的特征,结节分布及形态、支气管充气征及晕征、强化方式等征象有助于与其他疾病的鉴别。

Objective To investigate the thin-section computed tomography(CT)findings of solitary nodular-type pulmonary cryptococcosis,and to improve the understanding and diagnostic level of this disease.Methods A retrospective analysis was performed on the CT features and the clinical data of 42 cases of solitary nodular-type pulmonary cryptococcosis which were confirmed by surgical pathology or aspiration biopsy.Results Among the 42 cases,the lesion was located in the right lung in 28 cases and in the left lung in 14 cases.Most lesions(33 cases,78.57%)were located in the extrapulmonary area and most(73.81%)were nodules with a diameter of>10 mm.The accompanying signs on CT included halo sign(8 cases,19.05%),vascular convergence sign(26 cases,61.90%),air bronchogram sign(9 cases,21.43%),and spiculation(10 cases,23.81%).The nodules were quasi-circular(27 cases,64.29%)or irregular(15 cases,35.71%).Pleural indentation was observed in 12 cases(28.57%).A total of 21 cases underwent contrast-enhanced CT scans,and 10 cases(47.62%)showed moderate enhancement and 13 cases(81.25%)showed homogeneous enhancement.Conclusion Solitary nodular-type pulmonary cryptococcosis has certain characteristics on thin-section CT scans.The location and morphology of the nodule,air bronchogram sign,halo sign,and the enhancement pattern can help differentiate it from other diseases.