不同类型肺曲菌病的CT特点分析

目的探讨不同类型肺曲菌病的CT特点。方法回顾1999年1月～2010年9月收住笔者医院肺曲菌病40例,分析其胸部CT特点。结果患者中肺曲菌球病20例,15例表现为空气新月征,5例表现为空气环征,3例有滚珠征;变态反应性支气管肺曲霉菌病5例,4例患者发现中心性支气管扩张和支气管黏液栓形成,其中2例合并密度增高的牙膏样、指套样阴影;侵袭性肺曲霉菌12例,8例患者表现为两肺多发类圆形小结节周围包绕晕征,其中4例伴有楔型实变,2例表现为近胸膜下团块影,伴中心低密度影和空气新月症1例,2例见右肺大片云絮状密度增高影;阻塞性支气管曲霉菌病3例,2例浸润性团块阴影,1例右主支气管内低密度影,部分中间合并右侧中间段支气管腔堵塞。结论不同类型的肺曲菌病CT表现各具特点,认识这些特点对不同类型肺曲菌病的诊断具有重要意义。

CT Features of Different Types of Pulmonary Aspergillosis

Objective To identify the CT features of the pulmonary aspergillosis.Methods The CT appearance of forty patients with pulmonary aspergillosis treated from January 1999 to September 2010 were retrospectively analyzed.Results Twenty patients were diagnosed with pulmonary aspergilloma,of whom fifteen showed globular-like soft tissue shadow accompanied with crescent-shaped shadow in the chest CT images,five showed ring sign,three showed moving ball sign.Of the five patients with allergic bronchopulmonary aspergillosis,four showed central bronchiectasis and mucoid imoaction,two showed finger-in-glove opacities and toothpaste shadows.Eight of the twelve patients with invasive pulmonary aspergillosis showed bilateral nodules with the "hole sign",four showed pulmonary wedge shaped consolidation,two large area of subpleural,mass lesion,one hypodense sign and crescent-shaped shadow,two large area of patchy opacities in right lung lobe.Two of the three cases with obstructive aspergillus tracheobronchitis showed mass lesion.Conclusion Identification of the CT features is of particular value in the diagnosis of different types of pulmonary aspergillosis.