摘要
目的：提高对侵袭性肺曲霉菌感染（IPA）早期影像表现及随访中影像演变的认识。方法：回顾性分析22例IPA患者经平均96d随访（20~692d）的141次（平均6.4次）CT图像，动态观察IPA的影像特征、数量和大小的变化。结果：IPA首次检查的早期多表现为大小不等的结节，平均为1.39cm（范围0.3~3.7cm）。病变多发为主要形式，平均5.3个（范围1~20个）。病变周围伴有晕征是早期较为特征性的改变，出现率为77.3%（17/22）。在7~14d的影像随访期间，结节病变无论是数量还是大小在此期间均表现为增加的趋势，平均大小1.64cm（0.4~4.2cm），平均病变数量5.8个（1~23个）。平均23d（15~30d）时出现的空气半月征和空洞强烈提示IPA的诊断。结论：IPA好发于免疫缺陷患者，结节周围的晕征为CT的早期特征性表现，熟悉IPA的CT影像表现及演变过程对疾病的诊断、预后评价有重要意义。
Abstract
Objective: To improve the understanding concerning CT initial manifestations and changing course of invasive pulmonary aspergillosis(IPA). Methods: One hundred and forty-one serial CT scans(mean, 6.4) in 22 consecutive patients were reviewed retrospectively over a median follow-up of 96 days(20~692 days), number and size of lesions and CT manifestations of IPA were evaluated dynamically. Results: On CT initial imaging, multiple lesions usually were observed, median lesion number and size were 5.3(1~20) and 1.39cm(0.3~3.7cm) respectively. An accompanying halo sign was early characteristic CT signs of IPA and was observed in 77.3%(17/22) patients at the initial CT scans. During 7~14 days follow-up, both number and size of lesions showed increase, 5.8(1~23) and 1.64cm(0.4~4.2cm) respectively. The strongest predictive diagnosis of IPA was the formation of the air crescent sign and cavitation that evolved at a median 23 days. Conclusion: IPA mostly occurred in immunocompromised patients, An accompanying halo sign around nodes was early characteristic CT signs of IPA, familiar with its CT manifestations and changing course have an important significance in diagnosis and estimating prognosis.
关键词
肺疾病 /
真菌性 /
曲霉菌病 /
体层摄影术 /
螺旋计算机
Key words
Lung diseases /
fungal /
Aspergillosis /
Tomography /
spiral computed
黎 庶;张立娜;王 欣;刘 婷;李佩玲;谢秀丽;徐 克.
侵袭性肺曲霉菌感染CT征象的早期表现及其随访观察[J]. 中国临床医学影像杂志. 2009, 20(8): 611-614
LI Shu;ZHANG Li-na;WANG Xin;LIU Ting;LI Pei-ling;XIE Xiu-li;XU Ke.
Invasive pulmonary aspergillosis: initial manifestations and follow-up of CT imagings[J]. Journal of China Clinic Medical Imaging. 2009, 20(8): 611-614
中图分类号：
Ｒ563
Ｒ519.8
Ｒ814.42
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