艾滋病相关肺孢子菌肺炎影像学诊断

目的:分析艾滋病患者的肺孢子菌肺炎影像学特点。材料和方法:收集58例AIDS患者经临床诊断发生肺孢子菌肺炎的胸片(40例)和CT(20例),并分析其影像表现。结果:肺孢子菌肺炎的典型表现是两侧肺门周围对称性磨玻璃影、网状或网状结节影,呈斑片或地图状分布,由肺门向外周肺野发展并融合趋势;不典型表现为肺内多发结节、肺囊肿、胸腔积液、气胸、肺门及纵隔淋巴结肿大等。HRCT显示以上征象明显高于胸片。临床主要表现为低热、干咳、进行性呼吸困难及低氧血症。结论:艾滋病患者发生肺孢子菌肺炎时有一定的影像特点,影像检查有助于该病的诊断和鉴别。

Imaging Diagnosis of Pneumocystis Pneumonia in AIDS

Purpose:To study the radiologic characteristics of pneumocystis Jiroveci pneumonia(PJP)in patients with AIDS.Materials and Methods:The pneumocystis Jiroveci pneumonia were clinically con- firmed in fifty-eight AIDS patients.The radiologic findings were evaluated in the chest radiographs(n= 40)and CT scans(n=20).Results:The typical findings of PJP included the bilateral symmetrical ground-glass opacities,reticular or reticular-nodules infiltration,and patchy or geographic consolida- tion.The lesion had the trend expanding to periphery from the hila.Unusual findings included multiple pulmonary nodules,cysts,pleural effusion,pneumothorax,lymph node enlargement in hilar and medi- astinum.HRCT is more useful than chest radiograph in detection of pulmonary lesions.The main clinical presentation included unproductive cough,fever,and progressive dyspnea.Conclusion:The PJP in AIDS patients had the radiologic characteristics,which were helpful in the diagnosis and differential diagnosis of PJP.