肺真菌病的影像诊断及分析

目的研究肺真菌病的x线及cT表现，探讨其影像诊断要点。方法回顾性分析经病理及临床证实的21例肺真菌病的影像学表现。结果肺真菌病的影像学表现主要有肺炎性实变12例，坏死伴空洞12例及曲菌球6例，结节病灶及肿块12例，毛玻璃样阴影16例，肺门、纵隔淋巴结肿大2例，胸膜炎及胸腔积液8例。病理组织学及真菌培养结果为曲霉菌13例．白色念珠菌5例，隐球菌3例。结论肺真菌病的影像学表现复杂多变，是多发、多种形态的病变并存。出现曲菌球者可明确肺曲菌病的诊断，当出现弥漫混合病变（实变、结节病灶及肿块）、绕有“晕征”的结节时应考虑是否有真菌感染，并结合其临床可提高诊断率。

Imaging Diagnosis and Analysis of Pneumonomycosis

Objective To investigate the radiological characteristics of the pnenmonomycosis and to explore the diagnostic value of imageology diagnosis key points.Methods X-rat and CT images of 21 patients with pneumonomycosis confirmed by pathological and clinical observations were retrospectively analyzed.Results The radiological characteristics of pneumonmycosis revealed：twelve cases of pneumono-parenchvma;twelve cases with necrosis accompanied with cavities and 6 cases of aspergilloma; twelve cases with nodules and lumps;twelve cases with frosted glass like shadow;two cases with lymphomegaly at lung and mediastinum;eight cases with pleurisy and pleural effusion.Histopathologic examination and mycetes cultivation revealed Aspergillus infection in 13 patients, Blastomyces albicans in 5 cases and cryptococcus in 3 cases. Conclusion The radiological characteristics of the pneumonomycosis complications are variable. Widespread mixing lesions and a reversed halo sign are the indication of, fungal infection. Including other clinical observations may improve the accuracy of diagnosis.