白血病继发侵袭性肺曲霉菌病的CT影像分析
CT findings of secondary pulmonary aspergillosis infection in leukemia
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摘要: 目的:总结白血病继发侵袭性肺曲霉菌病(IPA)CT影像表现,提高对IPA的认识及诊断水平。方法:经病理或临床证实的25例白血病继发IPA者,记录其类型、分布、形态、数目、大小及影像特征。结果:25例中,实变型12例:单发斑片3例,多发斑片9例,有实变阴影5例,见支气管气相6例,内并发单发/多发小结节5例;具有出血性肺梗死改变征象15例,为尖端指向肺门,底边位于胸膜的楔形病灶,内可见支气管气相9例,同时见小空洞3例。肿块型7例:单发或多发结节或肿块7例,并发斑片病灶4例,周围见晕征5例;内见空气新月征2例。混合型6例:同时可见以上两型征象。其他:邻近胸膜显示增厚、粘连8例,2例病灶内见钙化。结论:白血病继发IPA的CT表现多样,结节+晕征和/或楔形实变影及支气管气相为具有一定意义的征象,有助于早期诊断,减少误诊。Abstract: ObjectiveTo summary CT manifestation of secondary pulmonary mycotic infection in leukemia, to improve diagnosis and understanding of the disease. Methods: Analyzed CT findings and clinical data of 25 cases of IPA in leukemia,record image characteristic of the type,distribution,morphology, size,number.Results: In 25 cases, 12 cases of consolidative, single patch in 3 cases,multiple patchy in 9 cases, there are real shadows in 5 cases,bronchial gas phase in 6 cases,5 cases of concurrent single /multiple nodules with hemorrhagic pulmonary infarction; change sign in 15 cases, for pointing toward the hilum,wedge-shaped lesions in the bottom of the pleura,bronchi and gas phase in 9 cases, at the same time to see the small cavity in 3 cases.Mass type: single or multiple nodules or masses in 7 cases,4 cases with patchy lesions, found around the halo sign in 5 cases; see air crescent sign in 2 cases.Six cases of mixed type,also visible above two.Others: Eight cases of adjacent pleural thickening and adhesion,2 cases with calcification. Conclusions: CT findings of IPA in leukemia are various,nodule and halo signand /or wedge consolidation and air bronchogram are the specific manifestation on CT images,which are contributed to diagnose early and reduce misdiagnosis.