血液病继发性肺侵袭性真菌病的HRCT征象的价值 - 第三军医大学学报.DOC

血液病继发性肺侵袭性真菌病的HRCT征象的价值 莫显斌1*、2 ，兰茜琳1 ，杨静1 ，陈伟1，杨春2，姚倩东2（400038 重庆 第三军医大学西南医院放射科1，621900 四川 绵阳 四川省科学城医院放射科2；*：进修生） 【摘要】：目的 探讨血液病患者继发肺侵袭性真菌病（IFD）的HRCT征象，评价其在IFD临床诊断中的价值。方法回顾性分析确诊和临床诊断的41例血液病患者继发性肺IFD的HRCT征象，分析病灶形态、分布、密度、边缘的HRCT特点及CT征象。结果所有病例均为多发病灶，分为毛玻璃型和实变型（n=23），结节肿块型（n=18），霉菌球型（n=7），粟粒型（n=3）。，实变型CT征象：病灶表现出晕轮征（n=15），磨玻璃征(n=15)，新月征或气环征(n=10)，楔形征（n=6），树芽征（n=3），反晕轮征（n=3），指套征（n=3），。结论 血液病患者继发肺侵袭性真菌病（IFD）肺内病灶呈多形态改变，同时出现两种以上病变形态，可提示IFD。楔形征、晕轮征、反晕征及新月征为肺IFD的较特征性征象，HRCT对IFD诊断均有重要价值。 【关键词】 肺;真菌病;体层摄影术,X线计算机 HRCT Sign of secondary pulmonary invasive fungal disease with hematologic diseases Mo Xianbin 1*,2 Lan Xilin1 Yang Jing 1 Chen Wei1，Yang Chun2，Yao Qiandong2 （1Department of Radiology, Southwest Hospital, Third Military Medical University, Chongqing,400038, China . 2Department of Radiology，Scientific City Hospital of Sichuan province.Mianyang Sichuan 621900） [Abstract] Objective:To assess the HRCT signs of pulmonary invasive fungal disease in hematologic diseases patients,and to evaluate the clinical value of the HRCT signs for identification of IFD. Methods ：HRCT imaging findings from 41 patients with IPD were systematically analyzed. On HRCT, the lesion shape, margin, type, location, presence of CT sign were evaluated.. Results : all cases presented multiple lesions in bilateral lung, All lesions appeared ground-glass and consolidation（n=23），nodules or mass（n=18），aspergilloma（n=7），military(n=3). halo sign (n =15), ground-glass sigan(n=15),crescent sign or air sling sign(n=10), wedge shaped sign(n=3),tree in bud(n=3), reversed halo sign（n=3）,hypodensesign (n=3) and finger-in-Glove Sign were found.conclusion： IFD predominantly presented as different lesion types on CT scan in immunocompromised pateints,IFD is associated with two or more type, which is considered highly-suggestive for IFD.. The wedge shaped sign，the halo sign，the reversed halo sign and the crescent sign are considered specific findings for IFD, ,HRCT have important value for IFD diagnos