急性白血病化疗后继发肺部真菌感染的CT诊断

目的 提高对急性白血病化疗后继发肺部真菌感染CT表现的认识. 资料与方法 回顾性分析25例急性白血病患者化疗后经病理、真菌培养及临床治疗随访证实的继发肺部真菌感染的CT表现. 结果 25例中CT表现为肺炎性浸润实变、结节型8例,炎性浸润实变、肿块型2例,炎性浸润实变、结节、肿块型4例,多发结节型6例,结节、肿块型5例;其中12例出现"晕征", 2例有"含气新月征"; 7例合并空洞,9例有楔形实变影.病灶在肺内的分布无特殊性. 结论 急性白血病化疗后继发肺部真菌感染CT表现为病变呈多灶性、多态性,真菌感染的"晕征"及楔形实变影是早期肺部真菌感染的较特征性CT表现.

CT Diagnosis of Secondary Pulmonary Mycotic Infection in Acute Leukemia after Chemotheraphy

Objective To improve the cognition of CT manifestations of secondary pulmonary mycotic infection in acute leukemia after chemotheraphy. Materials and Methods The CT manifestations of secondary pulmonary mycotic infection in acute leukemia after chemotheraphy in 25 cases confirmed by pathology, mycetes cultivation, and follow up of clinical theraphy were analyzed retrospectively. Results In all cases, 8 cases showed pulmonary inflammatory infiltration consolidation and nodus type, 2 cases showed inflammatory infiltration consolidation and tumour type, 4 cases showed inflammatory infiltration consolidation, nodus, and tumour type, 6 cases showed multiple nodus type, 5 cases showed nodus and tumour type. Among the 25 cases, Halo sign were showed in 12 cases, crescentic sign containing air in 2 cases, accompanying with cavities in 7 cases, wedge shape consolidation in 9 cases.There were no specificity of the distribution in lungs. Conclusion Secondary pulmonary mycotic infection in acute leukemia after chemotheraphy displaied as mulifocality and polymorphism in CT. Halo sign and wedge shape consolidation of mycotic infection are comparative distinctive CT manifestations of pulmonary mycotic infection in earlier period.