2型糖尿病合并肺毛霉菌病的临床与CT表现

Clinical and CT Manifestations of Type 2 Diabetes Mellitus Complicated with Pulmonary Mucormycosis

目的探讨2型糖尿病合并肺毛霉菌病的临床、CT表现,以提高诊断准确率。方法回顾性分析16例经病理确诊为2型糖尿病合并肺毛霉菌病患者的临床、CT影像资料。结果 16例中,12例血糖控制不佳,8例有酮症酸中毒症状。10例CT表现为双肺多发实变、肿块、磨玻璃影共存,6例表现单发病灶;13例病灶内见巨大空洞,空洞平均最大径4.2 cm,其中7例空洞内混杂稍低密度影与周围高密度洞壁形成反晕征;5例病灶周围可见晕征;4例侵犯支气管,2例侵犯肺动脉致肺栓塞。增强扫描实变区、肿块及洞壁呈不同程度强化。结论 2型糖尿病合并肺毛霉菌病的临床、CT表现多样。当患者有酮症酸中毒,CT表现为多发或单发病灶并见巨大空洞,洞内混杂稍低密度影与高密度洞壁形成反晕征时,应考虑肺毛霉菌病的可能。

Objective To investigate the clinical and CT manifestations of type 2 diabetes mellitus complicated with pulmonary mucormycosis and to improve its diagnostic accuracy.Methods 16 cases of clinical and CT imaging data in patients who were pathologically diagnosed as type 2 diabetes with pulmonary mucormycosis were retrospectively analyzed.Results Among the 16 cases,12 cases had poor blood glucose control and 8 cases had ketoacidosis.In 10 cases,multiple consolidations,masses,and ground-glass opacities coexisted in the lungs,and 6 cases showed single lesions;in the 13 lesions,huge cavities were seen,averaging 4.2 cm in size,of which 7 cases had mixed lower density in the hollow cavity,and formed a reversed halo sign with the surrounding high-density wall.Halo signs were visible around the lesions in 5 cases;bronchi were invaded in 4 cases;and pulmonary arteries were invaded in 2 cases to result in pulmonary embolism.Enhanced scanning of the consolidation area,the mass and the cavity wall displayed enhancement at different degrees.Conclusion The clinical and CT manifestations of type 2 diabetes mellitus combined with pulmonary mucormycosis are diverse.When the patient has ketoacidosis,CT indicates multiple or single lesions and the huge cavities can be seen.The possibility of pulmonary mucormycosis is taken into consideration when the hollow cavities are mixed with lower density and form a reversed halo sign with the surrounding high-density wall.