慢性肺曲霉菌病的CT动态观察

目的探讨慢性肺曲霉菌病病灶CT征象动态变化情况。方法搜集近9年具有完整临床资料及胸部CT检查资料的66例继发于陈旧性肺结核的慢性肺曲霉菌病患者。根据病灶的CT变化情况分为三组观察,将没有变化的稳定性病灶定为Ⅰ组,不稳定性病灶中,空洞形态改变的病灶定为Ⅱ组,空洞不变的(仅其内曲霉菌形态发生改变的病灶)定为Ⅲ组;回顾分析各组的临床资料及CT征象并进行对比。结果 1、Ⅰ组18例;Ⅱ组16例;Ⅲ组32例。2、与Ⅰ组对比,曲霉菌血清学检查阳性、炎症标记物阳性患者Ⅱ组及Ⅲ组多见(分别为Ⅱ组10/16、12/16及Ⅲ组24/32、19/32),免疫功能减低患者Ⅲ组多见(17/32)。3、含球简单空洞以Ⅰ组多见(11/18),非含球简单空洞以Ⅱ组多见(11/16),含球复杂空洞以Ⅲ组多见(20/32)。结论慢性肺曲霉菌病是动态发展的,对病灶进行胸部CT追踪复查能提高疾病的影像学诊断并为临床分型提供全面的影像学依据。

CT Follow-up Review of Chronic Pulmonary Aspergillosis

Objective To investigate the changing of lesions CT signs about chronic pulmonary aspergillosis.Methods 66 cases of chronic pulmonary aspergillosis second to obsolete pulmonary tuberculosis who had complete clinical and Chest CT data over the last 9 years were collected. All patients were divided into three groups according to the changing of lesions CT signs. The patients with the stable lesions which CT signs without changing were divided as Group Ⅰ, and with the unstable lesions who were divided into two groups as group Ⅱ and group Ⅲ. Group Ⅱ requires having invasive cavity, and Group Ⅲ requires the CT signs of aspergillus inside the cavity having changed and the cavity without changing. Reviewing and comparative analyzing clinical information and CT signs of each group.Results 1 We found 18, 16 and 32 cases of groupⅠ, group Ⅱ and group Ⅲ, respectively. 2 Compared with groupⅠ, The positive results for serological test and inflammatory makers for aspergillus were more common in group Ⅱ (10/16, 12/16) and group Ⅲ(24/32, 19/32), and the cases of immunocompromised patients were more common in group Ⅲ(17/32). 3 The CT signs of simple cavity with aspergilloma, simple cavity without aspergilloma and complex cavity with aspergilloma were most commonly found in groupⅠ(11/18), group Ⅱ(11/16) and group Ⅲ(20/32), respectively. Conclusion Chronic pulmonary aspergillosis are in a dynamic process of development. Through chest CT follow-up reviewing for lesions, we can raise the accuracy of radiological diagnosis in chronic pulmonary aspergillosis and provide complete radiological basis for clinical classification.