艾滋病合并卡式肺孢子菌肺炎的 CT 特点及与预后的关系

摘要

Objective:To summarize and analyze the CT imaging manifestations of pneumocystis carinii pneumonia (PCP)in AIDS patients and its relationship with prognosis.Methods:Fifty-five AIDS patients complicated with PCP were included and retrospectively analyzed in the present study between August 2014 and August 2015.All cases underwent CT scan and were poved by clinical and pathology.CT features and its relationship with prognosis were summarized.Results:Ground-glass opacity (n=55 )was themostly presented sign on CT.Other findings were including reticular pattern (n=25 ),nodular (n=19),consolidation (n=12),and pneumatocele (n=9).Rare findings were pleural effusion (n=2),pericar-dial effusion (n=1)and emphysema (pneumothorax,mediastinalemphesema,subcutaneous emphysema)(n=1).The com-mon distribution types were diffuse inhomogeneous (n=26),diffuse uniform (n=14),and parahilar (n=10).Subpleural distribution was quite rare (n=5).There was not any single lobar or lobular distributing type.The development of CT find-ings above were varied.The recovery rate of single ground-glass opacity group was not statistically significant compared with that of the mixed-sign group (P <0.05).Conclusion:PCP in AIDS patients has certain CT features,which can supply evidence for clinical diagnosis and prognosis assessment.%目的：探讨艾滋病合并卡式肺孢子菌肺炎（PCP）的影像特点及其与预后的关系。方法：回顾性分析2014年8月－2015年8月临床或病理确诊为艾滋病合并 PCP 55例患者的病例资料，总结其 CT 影像学特点，并探讨其与预后的关系。结果：艾滋病合并 PCP 最常见的影像特征为磨玻璃密度影，共55例，其次为网格影25例、结节19例、实变12例、肺气囊9例；少见表现：胸腔积液2例，心包积液1例，气胸、纵隔气肿、皮下气肿1例。常见分布类型：弥漫不均匀型26例，弥漫均匀型14例，肺门旁型10例；少见分布：胸膜下型5例，未见单一大叶或小叶分布型。上述影像特征动态变化呈多样性。单一磨玻璃密度组和多种征象混合组的治愈率差异无统计学意义（P ＞0．05）。结论：艾滋病合并 PCP 具有一定的影像学特点，这些能够为临床诊断及预后评估提供一定的依据。