CT引导下经皮肺穿刺活检对侵袭性肺真菌感染的诊断价值

摘要

目的 探讨CT导向下经皮肺穿刺活检对侵袭性肺真菌感染的诊断价值.方法 回顾性分析32例侵袭性肺真菌感染的病例资料,所有病例均行痰涂片、胸X线检查、胸部CT检查、纤维支气管镜检查、CT引导下经皮肺穿刺活检术,检出物送病理检查.结果 7例患者痰培养真菌阳性,纤维支气管镜检查肺泡灌洗液真菌培养均阴性,肺CT及胸X线表现为多发实变、结节状阴影、新月征、斑片状阴影、空洞征等.32例患者均经CT引导下经皮肺穿刺活检术(PCNB),其中28例检出物病理检查确诊为真菌感染.穿刺后无严重并发症.结论 对肺部难以确诊的侵袭性肺真菌病,CT引导下经皮肺穿刺活检是一种安全有效的方法.%Objective To explore clinical application of CT - guided percutancous cutting needle biopsy ( PCNB ) in the diagnosis of invasive pulmonary fungal infection ( IPFI ). Methods 32 patients diagnosed as having IPFI by PCNB, all patients by staining of sputum, all patients by chest radiography, all patients by fiberoptic bronchoscopy, and ali patients by CT scan. Result The result of examinations by staining of sputum and fiberoptic bronchoscopy were negative. Pulmonary tumor, consonlidation, meniscus sign, patchy shadow and/or hole sign were shown in chest radiography and CT. IPFI of case were diagnosed by histopathologic biopsy after PCNB. All cases of PCNB are safe. Conclusion PCNB is a safe and effective means in the diagnosis of invasive pulmonary fungal infection (IPFL)for those which can not be diagnosed by clinics.