【摘要】 目的探讨非活动性肺结核合并肺曲霉菌感染的临床影像表现,为临床早期诊断提供依据。方法收集20例(男14例,女6例)非活动性肺结核合并肺曲霉菌感染病例,分析其临床及CT影像学资料。结果 20例中肺结核病史最短9个月,最长31年,平均时间10.6年,临床表现以咳嗽、咳痰、咳血为主。肺曲霉球13例,慢性坏死性肺曲霉病4例,慢性空洞型曲霉病2例,慢性纤维化性肺曲霉病1例。发病部位以双肺上叶尖后段、下叶背段为主,基本与肺结核一致,影像表现为单发或多发病灶密度不均匀团块影、空洞影、新月形气体影,同时肺内可见纤维索条影等陈旧性肺结核病灶。结论非活动肺结核合并肺曲霉菌感染,60%在肺结核感染4年后确诊,且以肺曲霉球居多。CT主要表现为两肺上叶密度不均匀团块形、新月形气体影,同时伴有纤维条索影等陈旧性结核病灶改变。更多还原

【Abstract】 Objective To investigate the imaging findings of non-active pulmonary tuberculosis complicated by pulmonary fungal infection, and to provide evidence for its early diagnosis. Methods A total of 20 cases were collected based on the recruitment criteria, including 14 males and 6 females. Their clinical imaging data were retrospectively analyzed. Results The history of pulmonary tuberculosis ranged from 9 months to 31 years, with a mean of 10.6 years. The presenting symptoms included cough, expectoration and hemoptysis. As for pulmonary aspergillosis, 13 cases were diagnosed with aspergilloma; 4 cases with chronic necrotizing pulmonary aspergillosis; 2 cases with chronic cavitary aspergillosis and 1 case with chronic fibrosis of pulmonary aspergillosis. The lesions of pulmonary aspergillosis were commonly located at the apicoposterior segment of the upper lobes of both lungs, dorsal segment of the lower lobes of both lungs, which were consistent with that of pulmonary tuberculosis. The imaging demonstrations included singular or multiple heterogenous mass opacity, cavitary opacity, and air crescent opacity. Meanwhile, fibrous cords like opacity of old tuberculosis lesions were demonstrated in the lungs. Conclusion As for inactive pulmonary tuberculosis complicated by pulmonary aspergillosis, 60% of the cases are definitely diagnosed at 4 years after tuberculosis infection. Aspergilloma is the most common pulmonary aspergillosis complicating inactive pulmonary tuberculosis. CT scan demonstrations include heterogenous mass opacity and air crescent opacity at upper lobes of both lungs, occasionally accompanied by fibrous cords like opacity of old tuberculosis lesions.更多还原