目的：分析变态反应性支气管肺曲霉菌病的高分辨率CT（HRCT）表现。方法回顾性分析5例变态反应性支气管肺曲霉菌病患者的胸部HRCT的影像特点。结果5例变态反应性支气管肺曲霉菌病患者的胸部HRCT均可见中心性支气管扩张，其中1例可见中心性支气管扩张合并外周支气管扩张。5例均为双侧肺受累，上叶支气管扩张共累及10个肺叶，中叶（或舌叶）支气管扩张共累及8个肺叶，下叶支气管扩张共累及10个肺叶。2例为静脉曲张状、囊状、柱状支气管扩张混合型，2例为囊状和静脉曲张状扩张混合型，1例为囊状支气管扩张。5例患者的扩张支气管内见黏液嵌塞，形成指套样，牙膏状改变，其中2例为稍高密度；3例可见肺实变，2例可见树芽征，1例合并肺纤维化，1例合并肺淋巴结肿大，1例合并胸膜增厚。结论对于具有长期哮喘病史的患者，如HRCT显示有中央支气管扩张，尤其是扩张支气管腔内黏液嵌塞，且较高软组织密度影时，应考虑变态反应性支气管肺曲霉菌病的诊断。%Objective To study the HRCT of the lung of allergic bronchopulmonary aspergillosis (ABPA). Methods The HRCT imagings of 5 cases with ABPA were all reviewed retrospectively. Results The HRCT depict-ed central bronchiectasis in 5 cases, involving 10 superior lobes, 8 middle lobes and 10 lower lobes; 2 cases′ imag-ings showed as the combination of phlebeurysma, capsular and prismatical bronchiectasis while 2 cases were capsu-lar combined varicose veins-liked extension. Cystic bronchiectasis was seen in 1 case. The mucoid impaction of the dilated bronchial tree wee seen in all 5 cases, presenting as gloved-finger and toothpaste appearance, while some mu-cus were with slightly hyperdense in 2 cases and consolidation were found in 3 cases; 2 cases were bud-like. One case combined pulmonary fibrosis. Hilar lymphadenopathy was seen in 1 cases and pleural thickening in 1 case. Conclusion The diagnosis of ABPA should be considered if a patient with long-standing asthma whose HRCT demonstrates central bronchiectasis with slightly hyperdense mucoid impaction or high-attenuation calcification.
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