肺毛霉菌病CT表现(附4例报告并文献复习)

CT Findings of Pulmonary Mucormycosis:Report of 4 Cases with Literature Review

目的探讨肺毛霉菌病的CT表现。方法回顾性分析4例经病理活检证实为肺毛霉菌病患者的临床及CT影像资料。结果4例患者CT表现:1例双肺多发、3例单肺多发结节或肿块影。3例见树牙征、空气新月征,4例见晕征,2例见反晕征,2例见低密度征。4例患者均有不同程度气管及血管侵犯,1例侵犯左主支气管并肺动脉瘤形成,1例合并肺栓塞。4例均伴纵隔及肺门淋巴结增大。3例合并胸腔积液,2例合并心包积液。结论肺毛霉菌病影像学表现随着病程的变化表现为不同的胸部CT改变并肺外侵犯,当出现反晕征和低密度征,血管或支气管侵犯时,需考虑肺毛霉菌病的可能。

Objective To investigate the CT findings of pulmonary mucormycosis.Methods Retrospectively analysis of the clinical and CT data of 4 patients with pulmonary mucormycosis confirmed by pathological biopsy.Results The CT findings of 4 patients showed multiple nodules or masses in both lungs in 1 case,multiple nodules or masses in single lung in 3 cases,air crescent sign and tree-in-bud pattern in 3 cases,halo sign in 4 cases,reversed halo sign in 2 cases and hypodense sign in 2 cases.All the 4 patients had varying degrees of tracheal and vascular invasion,1 invaded the left main bronchus and had pulmonary artery aneurysm formation,and 1 had a combined pulmonary embolism.3 cases were complicated with pleural effusion,2 cases with pericardial effusion and 4 cases with mediastinal and hilar lymph node enlargement.Conclusion The imaging manifestations of pulmonary mucormycosis present different pulmonary CT changes with the course of the disease,pulmonary mucormycosis should be considered when the pulmonary CT presents with reversal halo sign and hypodense sign,vascular or bronchial are involved.