血液病继发性肺侵袭性真菌病的H RCT影像41例分析

摘要

Objective:To investigate the HRCT features of pulmonary invasive fungal disease (IFD)in patients with hematologic diseases,in order to assess the clinical value of the HRCT in the diagnosis of IFD.Methods:HRCT data of 41 patients with IFD were retrospectively analyzed.The location,shape,distribution,density and margin of the lesions were evaluated.Results:All cases presented multiple lesions in bilateral lung,including ground-glass and consolidation type (23 cases),nodular or masslike type (18 cases),aspergilloma (7 cases)and miliary type (3 cases).The main CT features of IFD were halo sign in 15 cases,ground-glass sign in 15 cases,crescent sign or air-ring sign in 10 cases,wedge-shaped sign in 6 cases,tree-in-bud sign in 3 cases,reversed halo sign in 3 cases and finger-in-glove sign in 3 cases.Conclusion:The lesions of pulmonary IFD in patients with hematologic diseases appear as different shapes.Two or more types of lesions on CT are highly suggestive of IFD.The wedge-shaped sign,halo sign,reversed halo sign and the crescent sign are considered specific findings for IFD.HRCT has important value in the diagnosis of IFD.%目的：探讨血液病患者继发肺侵袭性真菌病（IFD）的 HRCT征象，评价其在IFD临床诊断中的价值。方法：回顾性分析41例血液病患者继发性肺IFD的 HRCT资料，分析病灶部位、形态、分布、密度及边缘等特征。结果：所有病例均为多发病灶，分为毛玻璃型和实变型（n＝23），结节肿块型（n＝18），霉菌球型（n＝7），粟粒型（n＝3）。CT 征象：病灶可表现出为晕轮征（n＝15），磨玻璃征（n＝15），新月征或气环征（n＝10），楔形征（n＝6），树芽征（n＝3），反晕轮征（n＝3），指套征（n＝3）。结论：血液病患者继发 IFD 肺内病灶呈多形态改变。CT 上同时出现两种以上类型，可提示 IFD。楔形征、晕轮征、反晕征及新月征为肺IFD的特征性征象，HRCT对IFD诊断有重要价值。