肺曲菌病的多层螺旋CT诊断价值

目的析肺曲菌病的MSCT表现,提高对肺曲菌病的认识和诊断能力。方法对20例经病理和治疗随访证实的肺曲菌病进行回顾性分析。结果 20例中13例为曲菌球,7例为侵袭性肺曲菌病。双肺多发4例,右肺9例,左肺7例。CT表现为13例曲菌球均表现为空洞性结节,10例呈新月征,空洞壁厚薄不均,伴周围条索影。7例侵袭性肺曲菌病中,表现为不规则斑片、斑块浸润影或磨玻璃影4例,伴有节段性实变2例;表现为结节影和楔形实变影3例,周边有晕圈征。结论肺曲菌病的影像学表现多种多样,认识其在不同时期具有的相应某些特征性表现,有利于临床早期正确诊断并进行治疗。

The Value of MSCT in Diagnosis of Pulmonary Aspergillosis

Objective To improve the capability of diagnosis of pulmonary aspergillosis. Methods Twenty cases of pulmonary aspergillosis confirmed by pathology or therapeutic following-up were retrospectively summarized and analyzed. Results Apergilloma was found in 13 cases, invasive pulmonary aspergillosis in 7 cases. Twenty cases were respectively located at the right lung （n=9cases）,left lung （n=7cases） and both lung（n=4 cases）.The appearances of the pulmonary aspergillosis were as following： 13 cases showed a hollow lesion with the longest dimention about 10mm-40mm, of which thin wall cavity accompanying a nodule with the ＂meniscus sign＂was seen in 10 cases .The anomalous spotted or patchy opacification, mass like the mottling infiltration shadow and the ground glass shadow were seen in 4 cases, of which 2 cases accompaning by the segmental consolidation. The pulmonary nodular and subpleural wedge-shaped consolidation with the ＂halo sign＂ were seen in 3 cases. Conclusion Various imaging findings in pulmonary aspergillosis, and some special appearances at different phases are valuable to make earlier diagnosis and therapy .