三种常见肺部真菌感染CT表现的比较研究.pdfVIP

532 放射学实践 2013 年 5 月第 28 卷第 5 期 Radiol Practice ,May 2013 ,Vol 28 ,No. 5 ·胸部影像学· 三种常见肺部真菌感染 CT 表现的比较研究 李国雄，谢丽璇，陈友三，刘士远，施裕新 【摘要】 目的:探讨肺隐球菌病、侵袭性肺曲霉病(lPA) 、肺念珠菌病 CT 表现的差异，为其鉴别诊断提供依据。 方法:回顾性分析 43 例肺隐冻菌病、35 例侵袭性肺曲霉病、22 ~1 肺念珠菌病的 CT 表现，并对其 CT .f正象进行统计学分 析。结果:肺隐球菌病以单纯性结节或肿块影(79.1%) 为主要 CT 表现，而 IPA 及肺念珠菌病均以混合性病变(57.1%及 63.6%) 为主要表现，两者实变的发生率均显著高于肺隐球菌病(P 值均0.05) 。肺隐球菌病结节以多发聚集型出现的 概率显著高于 IPA(P= 0.004) , IPA J.，l肺念珠菌病结节以多发散在型出现的概率均显著高于肺隐球菌病(P 值均 0.05) ;肺隐球菌病结节中支气管充气征的发生率显著高于肺念珠菌病(P=O. 011) ， IPA 结节中空洞的发生率显著高于肺 念珠菌病(P=O. 008); IPA 的实变以胸膜为基底分布的概率显著高于肺隐球菌病(P=O. 00 1);肺隐球菌病的实变于支气 管周围分布且出现支气管充气征的概率显著高于 IPA(PO.O日。结论:肺隐球菌病、侵袭性肺曲霉病、肺念珠菌病的部 分 CT {正象存在显著差异，可为鉴别诊断提供依据。 E关键词】 肺疾病;真茵;体层摄影术，X 线计算机 E 中图分类号】 R519; R814.42 【文献标识码) A [文章编号) 1000-0313(2013)05-0532-05 A comparative study of the CT findings in three common pulmonary fungal infections LI Guo-xiong ,XIE Li-xuan , CHEN You-shan ,et aL Department of nuclear medicine ,Wuhan Gneral Hospital of CPLA Guangzhou Military Command ,Wuhan 430070 ,P. R. China [Abstract) Objective: To investigate the difference of CT features in pulmonary cryptococcosis and invasive pulmonary aspergillosis (lp A) as well as pulmonary candidiasis ,and to provide the basis for differential diagnosis. Methods: CT fin小 ings of 43 cases with pulmonary cryptococcosis ,35 cases with IPA and 22 cases with pulmonary candidiasis were retrospec- tively reviewed. Different patterns of CT scan abnormalities between them were compared by l or Fishers exact test. Results: The most common CT findings of pulmonary cryptococcosis were solitary or multiple nodules or masses (79. 1%) , while findings of IPA and pulmonary candidiasis were mixed pat