肺真菌病的影像征象分析与诊断_徐丽莹.pdfVIP

OI :10.13609/j.cnki.1000 -0313.2009.02.035 2009 2 24 2 　Radiol Practice, Feb 2009, Vol 24, No.2 1 7 · · 徐丽莹, 田志雄, 鲁植艳, 胡金香 【】　:分析肺部真菌感染的 X 线片及CT 征象, 以提高对该 的诊断水平。:对 19 例经临床 理组织 学检查或真菌培养证实为肺部真菌感染的影像学资料进行回顾性分析。:12 例表现为双肺多发 变, 其中3 例表现 为小的散在分布的斑片影, 9 例表现为弥漫混合 变即双肺多处渗出、实变与结节或肿块并存;3 例仅表现为肺段或亚段 肺不张;4 例曲菌球, 变换体位见其可改变位置, 周边可见新月形透亮带。 纤维支气管镜检查:3 例见 一侧支气管内乳白色 或黄白色新生物,4 例见段支气管或亚段支气管腔内新生物, 呈球状或条索状, 部分或完全堵塞支气管腔。钳夹有豆腐渣 样物。 理组织学检查及真菌培养结果:19 例中10 例为曲霉菌, 2 例新型隐球菌, 7 例白色念珠菌。:肺部真菌感染 影像学表现具有多样性。 出现典型曲菌球者可明确肺曲菌 的诊断, 若出现弥漫混合 变(渗出、实变与结节或肿块并 存)、绕有晕征的结节以及楔形实变影时, 应考虑是否有真菌感染可能。 【】　肺疾 , 真菌性;体层摄影术,X 线计算机;诊断 【】R814.42;R563　【】A 　【】1000-0313(2009)02-0167-03 Imaging Analysis and Diagnosis of Pulmonary Mycosis　XU Li-ying, TIAN Zhi-xiong, LU Zhi-yan, et al.epartment of Radi- ology,the Affiliated Zhongnan Hospital,Wuhan University,Wuhan 430071, P.R.China 【Abstract】　Objective:To obtain a deeper understanding of the imaging features of pneumomycosis and to improve its radiological diagnosis.Methods:The imaging findings of 19 cases with pneumomycosis were retrospectively analyzed.The diagnoses of all cases were comfirmed by histopathologic examination and mycetes cultivation.The images were reviewed by two radiologists who reached a decision by consensus.Results:Multiple lesions in both lungs were found in 12 patients, in- cluding diffused distribution patches in 3 cases, and widespread mixing lesions such as exudation, consolidation nodus or mass in 9 cases.Segment pulmonary atelectasis was the only appearance in3 patients.Aspergilloma was foundin other 4 ca- ses.Fiberoptic bronchoscopy:ivory white neoplasm was found in unilateral bronchus of 3 patients and in segmental bronchus of 4 patients.Histopathologic examination and mycetes cultivation:Aspergillus was found in 10 patients, cryptococcus histo- lyticus in 2 cases, and bla