肺真菌病临床影像学分析

目的：分析肺真菌病的临床影像表现，提高诊断水平。方法：回顾分析21例肺真菌病（穿刺/手术/支纤镜病理证实16例，痰培养及临床证实5例）的X线、CT表现。20例行胸部X线及CT检查，1例仅行胸片检查。结果：肺曲霉菌6例，肺隐球菌8例，肺念珠菌2例，肺毛霉菌3例，肺放线菌2例。左肺6例，右肺6例，双肺多发9例。多发病灶常位于胸膜下，且以两肺中下叶受侵最常见。呈单/多发结节或肿块/空洞10例；呈单/多发斑片影者4例；斑片与结节/空洞影混合者7例。晕征、新月征、洞中球征/滚珠征/悬球征/洞中丝征为本病较为特征性表现。结论：影像学表现典型者可做出诊断，疑似者应及时进一步检查，以免延误诊治。

X-ray and CT of pulmonary fungal diseases

Objective：To analyze the imaging manifestations of pulmonary fungal disease on X-ray and CT.Methods：Twenty-one cases with pulmonary mycosis were retrospectively analyzed.The diagnosis was confirmed by CT-guided needle biopsy （11）,surgery （2）,sputum exam （5）or bronchoscopy biopsy （3）.20 cases had both chest X-ray and CT scan,1 case had only chest radiography.Results：Pathogenic fungi in 21 patients included aspergillosis （6）,cryptococcosis （8）,candidiasis （2 ）,mucormycosis （3 ）and actinomycosis （2 ）.The lesions located in the left lung （6 ）,right lung （6 ）or bilateral lung （9）.Multiple lesions occurred often subpleural,usually in inferior of bilateral lung.Imaging findings showed solitary/multi-focal mass or nodule or cavitas （10）,solitary or multiple patchy foci（4）,patchy foci mixed with nodules（7）.＂Halo sign＂,＂meniscus sign＂or＂ball or suspension ball in cavity sign＂,＂silk in cavity＂were typical imaging manifestations of pulmonary fungal disease.Conclusion：In patients with typical imaging findings of pulmonary fungal diseases,correct diagnosis on X-ray or CT can be made.For those suspicious cases,further examination should be performed in order to avoid delays in diagnosis and treatment.