MSCT对肺真菌病的诊断价值

目的：探讨肺真菌病的多层螺旋CT表现,以提高对本病的诊断水平.方法：回顾分析23例肺真菌病患者的病例资料,其中经手术病理证实9例、痰和脑脊液培养证实7例、经皮穿刺活检证实2例、纤支镜刷检5例.全部痛例均行全肺MSCT扫描,14例行病灶处HRCT检查.结果：23例中表现为肺内散在结节影4例,直径1～3 cm,密度均匀,周围见＂晕轮征＂;肿块及空洞影6例,肿块直径〉3 cm,密度较高,周围可见＂晕轮征＂,其中4例有空洞形成,内壁光滑;肺部炎症样改变8例,多位于两肺中下部,病变可融合呈地图状或蜂窝样实变影,侵犯一个肺段或肺叶,似肺段性或大叶性肺炎的表现,其中胸膜下楔形实变影3例,不规则片状实变影5例;曲菌球5例,表现为空洞内边缘光滑的球形致密影,随体位而变化,并见＂空气半月征＂.结论：肺部真菌感染的MSCT表现复杂,病变分布广泛,呈多种性质、多灶性及多形性改变,MSCT能准确显示病灶的细节,是观察肺真菌感染的重要手段.

The value of multi-slice CT in the diagnosis of pulmonary mycosis

Objective:To study the multi-slice CT(MSCT) findings of pulmonary mycosis and to improve the diagnostic standard of this disease entity.Methods:The MSCT findings and clinical materials of 23 cases with pulmonary mycosis which proved by surgery(9 cases),sputum examination and cerebrospinal fluid culture for fungus(7 cases),percutaneous needle biopsy(2 cases),fibrobronchoscopy brush biopsy(5 cases) were retrospectively analyzed.All of the patients had CT scan,and 14 cases had HRCT scan of the focal lesion add...