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目的:通过动物实验探讨急性期肺白念珠菌病CT表现与病理学改变的关系。方法:24只新西兰大白兔随机分为实验组(n=21)及对照组(n=3),实验组通过经皮气管穿刺法建立兔肺念珠菌病模型,对照组用同样方法注入生理盐水。于接种后每隔1 d行胸部CT扫描,观察CT表现,并与病理改变进行对照。结果:成功建立13例兔肺念珠菌病模型,首次CT阳性表现出现于接种后2～10 d,包括实变影10例:其中小叶性分布6例,病理表现为肺泡炎性渗出;叶段性分布4例,病理表现为肺组织坏死或出血性渗出。磨玻璃影6例,多与其他征象并发,病理表现为出血或炎性渗出;结节影3例,聚集于支气管血管束周围,病理表现为肉芽肿性炎症。结论:原发性肺白念珠菌病急性期CT表现以实变影最多见,其次为磨玻璃影和结节影,各种征象可并发,不具特征性。
OBJECTIVE: To investigate the relationship between CT manifestations and pathological changes in acute stage of C. albicans by animal experiments. Methods: Twenty-four New Zealand white rabbits were randomly divided into experimental group (n = 21) and control group (n = 3). Experimental rabbits were given broncho-pulmonary candidiasis model by percutaneous tracheal puncture. . Thoracic CT scan was performed every other day after inoculation, CT findings were observed and compared with pathological changes. Results: Thirteen rabbits with pulmonary candidiasis were successfully established. The first positive CT findings were observed 2 to 10 days after inoculation, including 10 cases of real change: 6 cases were lobular distribution, pathological manifestations were alveolar inflammatory exudation, Sectional distribution in 4 cases, the pathological manifestations of lung tissue necrosis or hemorrhagic exudation. There were 6 cases of ground-glass opacities, which were complicated by other signs. The pathological findings were bleeding or inflammatory exudation. Three cases of nodules were clustered around the bronchovascular bundles. The pathological findings were granulomatous inflammation. CONCLUSION: CT manifestations of acute pulmonary candidiasis are mostly seen in real time, followed by ground glass and nodules. All kinds of signs may be complicated without any characteristic.