侵袭性肺曲霉菌感染CT征象的早期表现及其随访观察

目的：提高对侵袭性肺曲霉菌感染（IPA）早期影像表现及随访中影像演变的认识。方法：回顾性分析22例IPA患者经平均96d随访（20~692d）的141次（平均6.4次）CT图像，动态观察IPA的影像特征、数量和大小的变化。结果：IPA首次检查的早期多表现为大小不等的结节，平均为1.39cm（范围0.3~3.7cm）。病变多发为主要形式，平均5.3个（范围1~20个）。病变周围伴有晕征是早期较为特征性的改变，出现率为77.3%（17/22）。在7~14d的影像随访期间，结节病变无论是数量还是大小在此期间均表现为增加的趋势，平均大小1.64cm（0.4~4.2cm），平均病变数量5.8个（1~23个）。平均23d（15~30d）时出现的空气半月征和空洞强烈提示IPA的诊断。结论：IPA好发于免疫缺陷患者，结节周围的晕征为CT的早期特征性表现，熟悉IPA的CT影像表现及演变过程对疾病的诊断、预后评价有重要意义。

Invasive pulmonary aspergillosis:initial manifestations and follow-up of CT imagings

Objective: To improve the understanding concerning CT initial manifestations and changing course of invasive pulmonary aspergillosis(IPA). Methods: One hundred and forty-one serial CT scans(mean, 6.4) in 22 consecutive patients were reviewed retrospectively over a median follow-up of 96 days (20~692 days), number and size of lesions and CT manifestations of IPA were evaluated dynamically. Results: On CT initial imaging, multiple lesions usually were observed, median lesion number and size were 5.3 (1~20) an...