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目的研究螺旋CT薄层扫描在肺真菌感染诊断中的临床价值。资料与方法对38例肺真菌感染患者的螺旋CT薄层扫描图像进行分析,并结合病理学总结不同真菌的影像特征。结果38例中肺曲霉菌16例,螺旋CT薄层扫描主要表现为软组织密度结节或肿块(14/16),其中7例病灶周围形成浅淡的、“磨玻璃”样晕环;典型肺曲菌球表现为“空气半月征”(5/16)。肺隐球菌10例,CT表现为结节、团块及实变影,内部可见“细支气管充气征”(3/10)。肺白色念珠菌9例,表现为两肺野散在或布满大小不一、密度不均的絮片状影,边缘模糊,伴有大小不等的结节影。肺毛霉菌3例,表现为“磨玻璃”样及结节影。结论螺旋CT薄层扫描可以清晰显示肺内病灶的形态特点,提示“晕征”、“空气半月征”、“洞内球征”、“细支气管充气征”及“树芽征”较特异的征象。不同真菌种类其螺旋CT薄层扫描征象亦有所差别,但最终需结合病理学做出诊断。
Objective To study the clinical value of spiral CT scanning in the diagnosis of pulmonary fungal infection. Materials and Methods Thirty-eight patients with pulmonary fungal infection were analyzed by thin-slice spiral CT and analyzed the imaging features of different fungi by pathology. Results Thirty-six cases of Aspergillus flavus were identified in 16 cases. The CT scan showed mainly soft tissue density nodules or lumps (14/16), of which 7 cases formed a pale, “ground glass” halo. A typical pulmonary aspergillosis appears as a “half moon air sign” (5/16). Pulmonary cryptococcosis in 10 cases, CT showed nodules, clumps and consolidation of the shadow, the internal can be seen, “bronchial tube” (3/10). Candida albicans in 9 cases, manifested as scattered lung field or covered with different sizes, uneven density of the flake shadow, blurred edges, accompanied by nodules of varying sizes. 3 cases of pulmonary Mucor, manifested as “ground glass ” like and nodules. Conclusion The spiral CT scan can clearly show the morphological features of the lesions in the lung, suggesting that the “halo sign”, “air half moon sign”, “cave ball”, “bronchioles sign” and “Tree bud sign ” More specific signs. Different types of fungi spiral CT thin-layer scan signs are also different, but ultimately need to make a diagnosis in combination with pathology.