肺真菌病的影像学表现及诊断(附12例分析)

目的 评价肺真菌病的影像学表现并分析其价值和限度。方法 肺真菌病患者12例,男7例,女5例。手术病理证实4例,CT导向穿刺活检证实2例,痰培养真菌阳性6例。全部病例均行X线及CT检查,2例行增强CT检查,4例有随访系列X线片。结果 12例肺真菌病影像表现为肺段或叶的实变6例,厚壁空洞2例,结节或肿块2例,霉菌球2例。影像学正确诊断5例,误诊7例。结论 影像学对有特征性表现的肺真菌病可正确诊断,对于无典型表现者,密切结合临床及影像表现的动态观察对诊断本病非常重要。

CT diagnosis of pulmonary mycosis

Objective To evaluate the imaging appearances of pulmonary mycosis and analyze its value and the limitation. Methods 12 patients with pulmonary mycosis (male 7, female 5)were diagnosed by different methods. All results were proved by pathology (4 cases), CT guide needle biopsy (2 cases), and sputum culture (6 cases). Chest X-ray and CT examinations were performed on all patients, enhanced CT scan were taken on 2 cases, and follow-up X-ray were obtained on 4 cases. Results 12 cases of pulmonary mycosis showed consolidation in the segment or lobe of the lung (6 cases), cavity with thick wall (2 cases), nodule or mass (2 cases), and fungal ball (2 cases). With imaging diagnosis , 5 cases were correctly diagnosed and other 7 cases were misdiagnosed. Conclusion Pulmonary mycosis with charactersitic manifestation can be correctly diagnosed by imaging. For those patients atypical appearances, close combination with clinical findings and follow-up imaging examination are important.