免疫正常肺曲霉菌患儿的CT表现

目的探讨免疫正常肺曲霉菌病患儿的CT表现。方法回顾分析经临床确诊的15例无基础疾病及免疫缺陷肺曲霉菌病患儿的临床资料和CT表现。结果 15例中,13例表现为肺内多发结节,其中细支气管周围分布10例,粟粒结节7例;12例实变,其中沿肺叶分布6例,小斑片影6例;6例支气管扩张,其中呈柱状扩张5例,呈串珠状扩张1例;6例支气管壁增厚;5例空洞,在上中(舌)肺叶支气管周围分布4例,厚壁空洞4例,薄壁空洞1例。随访发现12例痊愈,2例未愈,1例死亡。结论年龄小于2岁免疫正常儿童长期发热,CT主要表现为肺内小结节、实变、支气管扩张及空洞时,应该高度警惕肺曲霉菌感染的可能性。

CT findings of pulmonary aspergillosis in immune normal children

Objective To explore CT findings of pulmonary aspergillosis in immune normal children. Methods CT and clinical data of 15 immune normal children with pulmonary aspergillosis were analyzed retrospectively. Results Pulmonary aspergillosis consisted of pulmonary multiple nodules was found in 13 cases, consolidation in 12 cases, bronchiectasis in 6 cases, bronchial wall thickening in 6 cases, cavitations in 5 cases. Of 13 cases with pulmonary multiple nodules, peribronchiole distribution was found in 10 cases, miliary nodules were found in 7 cases. Of 12 consolidation cases, the segmental and subsegmental lobes distribution was observed in 6 cases, and patchy shadow in 6 cases. Six patients had bronchiectasis, of which 5 were cylindrical bronchiectasis and 1 was moniliform bronchiectasis. Cavitations were found in 5 cases, with thick-wall in 4 cases and thin-wall in 1 case, 4 of which were distributed in upper or middle lobes. Follow-up showed 12 children were cured, 2 not cured and 1 died. Conclusion Pulmonary aspergillosis should be highly suspected in immune normal children of less than 2 years old with long-term fever, whose main CT findings showed nodule, consolidation, bronchial dilatation and cavitations.