MSCT 对肺真菌病的诊断价值.pdf

T:271000null,DD(ayaI；),$S()Te:(1972-),3,V,D=,1VYCTMRITbnullnullMSCTk)hN闫呈新,岳云,付建斌,贾明胜K1!null: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bZE: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a痰和脑脊液培养证实7例a经皮穿刺活检证实2例a纤支镜刷检5例b全部病例均行全肺MSCT扫描,14例行病灶处HRCT检查bT:23例中表现为肺内散在结节影4例,直径13cm,密度均匀,周围见晕轮征#；肿块及空洞影6例,肿块直径3cm,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#b:肺部真菌感染的MSCT表现复杂,病变分布广泛,呈多种性质a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b1oM!null肺疾病；真菌；体层摄影术,X线计算机；诊断ms|!R814.42；R563.1nullDSM!AnullcI|!1000null0313(2010)11null1228null03ThevalueofmultinullsliceCTinthediagnosisofpulmonarymycosisnullYANChengnullxin,YUEYun,FUJiannullbin,etal.DepartnullmentofRadiology,MedicalImagingCenter,theAffiliatedHospital,TaishanMedicalCollege,Shandong271000,P.R.ChinaAbstract!nullObjective:TostudythemultinullsliceCT(MSCT)findingsofpulmonarymycosisandtoimprovethediagnullnosticstandardofthisdiseaseentity.Methods:TheMSCTfindingsandclinicalmaterialsof23caseswithpulmonarymyconullsiswhichprovedbysurgery(9cases),sputumexaminationandcerebrospinalfluidcultureforfungus(7cases),percutanenullousneedlebiopsy(2cases),fibrobronchoscopybrushbiopsy(5cases)wereretrospectivelyanalyzed.AllofthepatientshadCTscan,and14caseshadHRCTscanofthefocallesionadditionally.Results:Ofthe23patientswithMSCT,therewerescatterednodules(4cases)withthediameterof13cm,homogeneousindensityandperipheralhalosign#.Massandcavinulltyformationwereseenin6cases,withthediameter3cm,surroundwithhalosign#；cavityformationwithsmoothinnerwallwasseenin4cases.Pulmonaryinflammationwasseenin8cases,mostofthelesionslocatedatthemiddleandlowerpartoflung,mapnulllikeorhoneycombnulllikeconsolidationinvadingonesegment/lobewasassessed；subpleuralwedgenullshapedconsolidationwasseenin3cases,irregularpatchyconsolidationin5cases.5casesprovedtohaveaspergilloma,manifestedasanintranullcavitarysphericalshaped,highdensityshadowwithsmoothcontour,andmovedinaccordancewiththeposturalposition,meniscussign#couldalsobeassessed.Conclusion:MSCTfeaturesofpulmonarymycosisvariedaswidelydistribunullted,multinullfocalandpleomorphic,thedetailsofthelesionscouldbeaccuratelyrevealedonMSCT,whichplaysanimportantroleintheevaluationofpulmonarymycosis.Keywords!nullPulmonarydiseases；Mycosis；Tomography,Xnullraycomputed；Diagnosisnullnullk)h?hVs?Hqh)bv?$hsa8f?,?)8=3N7hbh5VC+s,?ahM,bYVs23k)hCTHRCTVC,4hMbZEF23310,o13,M-1776,(53b(UaUhN；66,6；?12,；ea5bh?,Kr1Mbh(?%h,sYEk%h3,k6,U3,Uh5(1oHi00S)h),?hv47bZEmh_9,Q_7,O_2,85_#_5bPGELightSpeedPlus4CT,h?CT_#CT,14hM)HRCT_,4H93cm,9Vn#(m2),?v2a?v4,4ba=C；(m3)；kM8,bL)3,kQ)5,k/,vlB,Hb,hMVmLM,SUBkk=,kv=kVC(m4),/sLM3(m5),?5LM3,mLM2；)o5,(w)h,VCb=H；o,87M,inb#,1%hVn)o=)(m6)bVC:k%v2,8A5,g4b)null1.k)h?hy#5S)Hqh),SUa*,7OVSU=#a,k?hqKbk)hV?,1?,ah%hP8f?/,6BZv.v4i?k)CTVC(5)J.rBK,2007,4(11):36null39.5nullLeungAN,GosselinMV,NapperCH,etal.Pulmonaryinfectionsafterbonemarrowtransplantation:clinicalandradiographicfindnullingsJ.Radiology,1999,210(3):699null710.6null,.kw)