26例肺真菌病的CT表现分析

目的提高对肺真菌病CT表现的认识．方法对26例有完整临床、CT、实验室、病理检查资料的肺真菌病进行回顾性分析．结果肺炎型13例，其中12例为白色念珠菌感染；肿块型7例，分别为曲菌感染6例，隐球菌感染1例；曲菌球4例，为曲菌及毛霉菌感染各2例；胸膜炎型及粟粒型各1例，为白色念珠菌及组织胞浆菌感染．本病CT表现易出现空洞、结节、渗出、纤维化、钙化等多种病灶并存，其中曲菌球及白色念珠菌性肺炎有一定的CT特征．曲菌球可见菌体随体位移动、空气新月征及晕征，白色念珠菌性肺炎为广泛的磨玻璃影、肺纹理增粗及支气管气相．部分病例易误诊为肺癌、肺结核、细菌性肺炎．结论曲菌球性肺炎和白色念珠菌性肺炎CT表现有一定特征，肺真菌病CT表现与肺癌、肺结核等肺疾患相似，确诊需要结合病史治疗、实验室和病理检查．

CT Findings of Pulmonary Myosis:Report 26 Cases

Objective To improve the knowledge of CT findings of pulmonary mycosis. Methods The CT findings of 26 cases of pulmonary mycosis confirmed by surgery, CT scan, sputum culture or lung biopsy were retrospectively analyzed. CT scan was performed on all cases. Results There were 13 cases showed the characteristics of pneumonia; 7 cases showed masses; 4 cases showed fungle ball; lcase was showed pleura; 1 cases showed little nodule. Pulmonary myosis had no characteristic in clinic. There were cavity, nodule, exudation, fibrosis and calcification in CT imaging. Pneumonia infected by aspergillus and monilia alba had special signs. Fungle ball moved with changing gesture. Some cases were diagnosed incorrectly as lung cancer, pulmonary tuberculosis or bacterial pneumonia. Conclusions Pneumonia infected by aspergillus or cryptococcus can easily be diagnosed incorrectly. At this time, we should combine the case history and the cure. Final diagnosis relies on the laboratory examination and pathology examination.