目的探讨肺真菌感染的CT表现 及与肺癌、肺结核的鉴别诊断。方法 搜 集36例经病理证实的肺真菌感染的64层CT 检查资料，同时随机搜集同期肺癌、肺结 核各30例患者的CT资料作为对照组。对研 究组、对照组的影像学资料进行综合分 析，并分别比较两者CT征象有无统计学差 异。结果 36例肺真菌感染患者中，双肺 病灶26例，斑片、结节型15例，肿块型 13例，实变型8例；主要征象包括浅分叶 征、深分叶、支气管充气征、长毛刺、短 毛刺、空泡、晕征等；肺癌组中深分叶、 支气管充气征、长毛刺、晕征出现频数明 显较研究组少，而凹陷征、空泡征和纵隔 淋巴结肿大明显较多(P＜0.05)；结核组 中浅分叶、深分叶、支气管充气征、长毛 刺、短毛刺和晕征出现频数明显较研究 组少，而卫星灶、钙化、淋巴结肿大明 显较多(P＜0.05)。增强扫描，肺真菌感 染病灶CT值增加值与两对照组比较有统 计学差异(t1=5.62，P＜0.05 t2=5.71，P ＜0.05)。结论 肺部真菌感染影像学表现 具有多样性，出现典型曲霉菌球的“新月 征”可明确肺曲霉菌病的诊断，若出现磨 玻璃影及“晕征”是真菌感染病灶较具特 征性的表现；此外，双肺多发病灶，征象 多样，且变化快，提示真菌感染可能。

Objective To discuss the CT manifestation of pulmonary fungal infection, and the differential diagnosis of lung cancer and tuberculosis. Methods Collecting 36 cases confirmed by pathology, CT examination data of 64 layer of pulmonary fungal infection, at the same time random collection period lung cancer and tuberculosis all CT data of 30 patients as control group. Analyzing the imaging data of the team, the control group, and compare the two respectively CT signs Presence of Statistical differences. Results 36 cases of pulmonary fungal infection in patients, mostly in the stove double lung disease 26 cases, patch, nodular type 15 cases, tumor type 13 cases, solid variant 8 cases; The Mainly signs include shallow lobulation,deep lobulated, the air-filled bronchi, long burr, short burr, cavitation and halo sign; In lung cancer group deep lobulated, air-filled bronchi, abnormal bronchial beam, long burr, halo sign appear frequency relatively less research obviously, and sag,cavitation,mediastinal lymph nodes enlargement, more obvious than the team between statistical differences (P<0.05); TB group shallow lobulation sign,deep lobulated sign, air-filled bronchi, abnormal bronchial beam, short burr,long burr, and halo sign appear frequency relatively less research group obviously, and satellite stove, calcification, lymph nodes are enlarged, more obvious than team between statistical differences (P<0.05). Enhanced scan, the CT added value of pulmonary fungal infection was statistical difference with the control group (t1=5.62, P<0.05 t2=5.71, P<0.05). Conclusion Pulmonary fungal infection imaging findings with diversity,"crescent sign" appears typical aspergillus ball can clear the diagnosis of pulmonary aspergillosis, if appear ground glass shadow and "halo sign" is the expression of the fungal infection lesions are more characteristic; In addition, the double lung multiple lesions, signs, and change quickly, suggest possible fungal infection.