免疫抑制状态下并发肝脏真菌感染的CT表现

目的:探讨免疫抑制状态下肝脏真菌感染的临床和CT表现及CT诊断价值。方法:9例经临床和/或病理证实的免疫抑制状态下肝脏真菌感染的患者,采用16层CT机行平扫及3期增强扫描。9例患者经抗真菌治疗1～3个月后复查,肝、脾病灶体积缩小,病灶数量减少或完全消失。结果:9例中7例CT表现为肝内多发类圆形低密度影,2例肝内弥漫分布小结节状低密度影,直径0.4～4.8cm,部分病灶边界清楚,增强扫描后病灶无强化或呈轻度～中度环形强化;其中2例可见脾内多发低密度影,强化方式与肝内病灶相同。结论:CT检查能很好显示肝真菌感染,并能对抗真菌治疗后疗效进行评价。

CT Features of Liver Fungal Infection in Immuno-compromised Patients

Objective:To study the CT findings and clinical manifestations of liver fungal infection in immuno-compromised patients.Methods:9 immuno-compromised patients with clinical and/or pathology proved hepatic fungal infection had CT examinations,including precontrast,arterial,portal as well as delayed phase after contrast enhancement.All of these 9 patients had follow-up CT 1~3 months after anti-fungal therapy,showing disappearance,shrinkage or lessening of the liver and spleen lesions.Results:Of the 9 patients,multiple round shaped,hypo-attenuated lesions were showed in 7 patients,diffuse small hypo-attenuated nodular lesions in 2 patients.The diameter of these lesions ranges from 0.4 to 4.8cm,part of them showed well-defined margin.After contrast media administration,no or mild to moderate ring-like enhancement were assessed.Two patients had involvement of spleen with the enhanced pattern similar to that of liver.Conclusion:Liver fungal infection in immuno-compromised patients could be clearly displayed on CT images,the efficacy of anti-fungal therapy could also be well evaluated.