艾滋病并发卡氏肺孢子虫肺炎的X线和CT诊断

Imaging Diagnosis of Pneumocystis Carinii Pneumonia in Patients with Acquired Immunodeficiency Syndrome

目的 :探讨艾滋病 (AIDS)并发卡氏肺孢子虫肺炎 (PCP)的胸部X线和CT表现。材料和方法 :对 6例经证实的艾滋病并发卡氏肺孢子虫肺炎患者的胸部X线照片 ( 6例 )和CT扫描 ( 2例 )进行回顾性分析。结果 :典型表现为双侧肺门周围以及中、下肺野弥漫性网状阴影 ,部分渗出性病变可以相互融合 ,呈斑片样或磨玻璃样改变。少见表现有肺囊性改变、肺实变、肺门淋巴结增大、胸腔积液及气胸等。结论 :艾滋病并发卡氏肺孢子虫肺炎的特异性诊断是找到病原体 ,但是HIV抗体检测阳性者出现典型胸部影像表现结合临床症状 ,并排除其他免疫低下所致的细菌性感染或肿瘤 ,复方新诺明治疗有效 ,诊断AIDS并PCP可以成立。

Purpose: To describe the chest X ray and CT manifestations of pneumocystis carinii pneumonia(PCP) in patients with acquired immunodeficiency syndrome(AIDS). Materials and Methods: Six cases of PCP in AIDS proved by laboratory were retrospectively studied.Among those cases,the manifestations of chest film were obtained in six cases, the manifestations of CT in two cases. Results: The typical features of PCP included diffuse reticulo nodular changes and infitration patch or ground glass opacification which distributed in bilateral hilar regions and middle lower lung fields .Unusual manifestations included cystic lesions,lobar consolidation,hilar adenopathy ,pleural effusion and pneumothorax,etc. Conclusion: Usually establishing diagnosis of PCP requires the morphologic demonstration of the microorganism,but it is possible to diagnosis of PCP in patients with positive HIV by typical imaging manifestations and clinical symptoms when the bacterial infections or the tumors caused by immunodeficient diseases except for AIDS can be excluded and it is effective treatment with SMZco.