艾滋病患者合并肺部机遇性感染性疾病CT影像学特征及诊断_精品.doc

艾滋病患者合并肺部机遇性感染性疾病CT影像学特征及诊断 ? 医学影像?2010年1月第48卷第2期 艾滋病患者合并肺部机遇性感染性疾病cT影像学特征及诊断 邹红群李松李全康杨俊涛 (云南省大理州人民医院放射科CT室,云南大理671000) 【摘要】目的探讨HIV/AIDS患者肺部机遇性感染CT表现特点.方法回顾性分析大理州人民医院感染科临床及病理 检验证实的114例AIDS患者的肺部影像学表现.全部病例均有完整的X线胸片资料,其中45例同时行CT扫描,部分 行HRCT扫描.结果AIDS合并肺孢子型肺炎(PCP)45例,典型表现为双侧肺周旁到中下肺野弥漫对称性分布的网格状 影,部分融合成斑片状,结节状影或呈毛磨玻璃样改变.HIV合并肺结核15例,细菌性肺炎4例,其影像学表现与普通肺结 核及肺炎表现类似.HIV合并肺真菌感染26例,表现为肺空洞内霉菌球形成,可见空气新月征.淋巴瘤2例,表现为肺内斑 点,斑片状影,肺门纵隔淋巴结肿大.卡波济氏肉瘤1例,表现为肺内多发大小不等结节影.结论CT检查是AIDS基本的 影像学检查方法,能更好地显示病变的部位,形态以及细微病变.双肺磨玻璃影,网状影,碎石路征为艾滋病伴肺孢子型肺 炎(PCP)的特征性表现. 【关键词】艾滋病(获得性免疫缺陷综合征);机遇性感染;肺孢子菌肺炎;螺旋CT扫描 【中图分类号】R512.91[文献标识码】A【文章编号】1673—9701(2010)02—78—03 CTImagingFeaturesandDiagnosisofPulmonaryopp0rtunistic InfectioninPatientswithAIDS ZOUHongqtmSongLIQuankangYANGJ~mtao CTRoomofX—rayDepartment,DaliAreaPeople’SHospital,Dali671000,China 【Abstract】ObjectiveToinvestigatetheCTimagingfeaturesoflungopportunisticinfectioninpatientswithAIDS.MethodsA retrospectiveanalysiswasmadeoflungimagingfeaturesof114casesofAIDSconfirmedbyclinicalandpathologicalexaminationfrom DepartmentofInfectionofDaliAreaPeople’SHospita1.AllpatientshadcompleteinformationonX～ray,inwhich45caseshadCT scanningwithsomeofHRCTscanning.ResultsTherewere45casesofAIDSwithpneumocystiscariniipneumonia(PCP)whose typicalmanifestationsshoweddiffusesymmetricalgridshadowfrombilateralpulmonaryaroundtothemiddle-lowerlungfield,someof theshadowmergingintopatching-likeandnodularshadoworshowingaground—glass—likechange.Theimagingmanifestationsshowed pulmonarytuberculosisin15casesofHIVandbacterialpneumoniain4casesofHIV.similartoordinaryTBandpneumonia.The imangmanifestationsshowedpulmonaryfungalinfectionin26casesofHIV,withfungusballsformedandaircrescentsignseenin thelungcavity.Twocasesoflymphomashowedthelungsspotsandpatchyshadowandhilarmediastinallymphnodeenlargementand onecaseofKaposi’ssarcomashowedmultiplepulmonarynodulesofvaryingsizes.ConclusionCTscanningisabasicAIDSimaging examination,andcanbetterdisplaythelesionsite,shape,andsubtlelesions.ThecharacteristicfeaturesofA