艾滋病患者肺部疾病的影像学诊断

目的分析艾滋病患者肺部疾病的影像学特征,并评价其在鉴别诊断中的意义。方法 12例经临床证实的艾滋病患者肺部疾病,包括卡氏肺囊虫感染7例,卡波氏肉瘤2例,肺结核2例,以及真菌感染1例,均经胸部X线检查,8例又经胸部CT扫描,对所有患者的影像表现进行了回顾性分析。结果 7例卡氏肺囊虫感染表现为双肺弥漫性病变,呈网状合并斑片状、结节状及磨玻璃样影,2例卡波氏肉瘤表现为直径小于等于1cm的结节影,沿支气管血管分布,伴小叶间隔增厚或淋巴结肿大,2例肺结核表现为血行播散型和浸润型各1例,1例真菌感染表现为肺内结节伴空洞形成及空洞内结节与气体半月征。结论胸部X线与CT检查在艾滋病患者各种肺部疾病的鉴别诊断中起重要作用。

Imaging diagnosis of pulmonary diseases in patients with AIDS

Objective To analyze the imaging features of pulmonary diseases in patients with acquired immunodeficiency syndrome （AIDS） and to evaluate their significance in the differential diagnosis. Methods Twelve patients with clinically proved pulmonary diseases in AIDS patients who comprised 7 pneumocystis carinii pneumonia （PCP）, 2 kaposi＇s sarcoma （KS）, 2 tuberculosis （TB）, and 1 fungal infection （FI） underwent chest radiography. 8 patients underwent additional chest CT scanning. Imaging findings of all patients were analyzed retrospectively. Results 7 cases of PCP presented with diffuse pulmonary lesions which were reticular shadows associated with mottling, nodular and ground-galss opacities. 2 cases of KS presented with nodular shadows distributed along peribronchial vessels （less than or equal to 1 cm in diameter） and lobular septum thickening or lymphonodus enlargement. 2 cases of TB presented as military pattern and infiltrative pattern in 1 each. One case of FI presented with intrapulmonary nodular shadow associated with cavitary formation and intracavitary nodule and air-crescent sign. Conclusion Chest radiography and CT scanning play important role in the differential diagnosis of varied pulmonary diseases in patients with AIDS.