论著-头颈部
侵袭性肺曲霉菌感染MSCT特征及对预后的评价*
作者:印为武1 彭 卫2 戚继荣2
所属单位:1.江苏省泰兴市第二人民医院CT、MRI室 (江苏 泰兴 225411) 2.南京医科大学附属南京儿童医院外科 (江苏 南京 210008)
PDF摘要
目的 观察侵袭性肺曲霉菌感染 MSCT特征,探讨MSCT对其预后的评价价 值。方法 选择2011年2月-2015年10月间 115例拟诊为侵袭性肺曲霉菌感染的患者 为研究对象,均接受胸部MSCT检查,观察 侵袭性肺曲霉菌感染的MSCT征象,比较血 液病与非血液病患者侵袭性肺曲霉菌感染 MSCT征象,并分析治愈好转组及恶化死亡 组患者治疗0W、2W、4W及8W肺部病变形态 学变化。结果 在85例确诊的侵袭性肺曲 霉菌感染中,MSCT共正确诊断81例,其 MSCT表现包括斑片影、实变、团块影、结 节、空洞、星月征、枝桠征及晕轮征,其 中空洞例数最多,其次为结节、斑片影及 晕轮征。病变以双侧多发为主,中下肺多 见。与非血液病患者侵袭性肺曲霉菌感染 MSCT征象比较,血液病患者斑片影、团块 影、结节、空洞、星月征、枝桠征及晕轮 征的比例均显著增高,组间比较差异具有 统计学意义(P<0.05)。治疗4W及8W,治 愈好转组斑片影、结节及空洞病灶的比例 均显著低于恶化死亡组,差异具有统计学 意义(P<0.05)。结论 MSCT能够准确显示 侵袭性肺曲霉菌感染病灶的特征,具有很 高的诊断准确率,并可以对患者预后进行 评估。
Objective To observe the MSCT features of invasive pulmonary fungal infection, To evaluate the prognostic value of MSCT. Methods 115 cases diagnosed as invasive pulmonary aspergillosis patients from February 2011 to October 2015 were chosen as the research object, all underwent chest MSCT examination, To observe the MSCT findings of invasive pulmonary aspergillosis, Comparison of blood disease and blood disease of non invasive pulmonary aspergillosis MSCT signs, Analysis and cure group and death group of patients with deterioration of the changes of 0W, 2W, 4W and 8W in treatment of pulmonary lesion morphology. Results Invasive pulmonary aspergillosis in 85 cases of infection, 81 cases were diagnosed correctly by MSCT, The MSCT findings included patchy shadow, consolidation, mass, nodules or cavities, and branches of sign, sign and halo sign, The maximum number of empty, Followed by nodules, patchy shadow and halo sign. Lesions in the bilateral multiple, middle and lower lung. With the blood disease of non invasive pulmonary aspergillosis MSCT features, The blood spot disease shadow, mass, nodules or cavities, and sign, sign and halo sign is the proportion of branches were significantly increased, The differences between groups were statistically significant (P<0.05). The treatment of 4W and 8W, the cure group shadow plaques, nodules and lesions void ratio were significantly lower than the deterioration of the death group, The difference was statistically significant (P<0.05). Conclusion MSCT features of invasive pulmonary aspergillosis lesions accurately, Has a high diagnostic accuracy, It can evaluate the prognosis of patients.
【关键词】螺旋CT;真菌;曲霉菌;肺部;感染
【中图分类号】R322.3+5
【文献标识码】A
【DOI】10.3969/j.issn.1672- 5131.2017.01.018
前言
由于抗生素不规范应用、菌种变异等因素,侵袭性肺曲霉菌感染 的发病率近年来不得升高。在机体免疫功能低下的患者,侵袭性肺曲 霉菌感染的概率更高,尤其多见于血液系统疾患、恶性肿瘤晚期、免 疫功能缺陷等患者,老年人发病率高于中青年人[1-2]。其临床表现无特 异性,痰培养发现真菌病原体是其诊断的金标准。多层螺旋CT(MSCT) 是肺部疾患最佳的影像学检查方法,通过各种后处理技术能够显示肺 内病变的特征,定位和定量诊断准确,经对病变形态学特征的评价, 定性诊断准确率高[3]。且可以用于随访观察,显示肺内病灶的变化情 况,从而指导临床诊疗。本研究中,研究者通过对侵袭性肺曲霉菌感 染胸部MSCT分析,观察和分析了侵袭性肺曲霉菌感染MSCT特征,并探 讨了MSCT对其预后的评价价值,报告如下。
中国CT和MRI杂志
第15卷, 第 1 期
2017年01月
相关文章