【摘要】 目的 评估肺侵袭性真菌病(IFD)和细菌性肺炎高分辨率CT的比较研究价值。方法 回顾分析208例IFD(n=102)或细菌性肺炎(n=106)的CT表现。将肺阴影分为实变型、磨玻璃样阴影(GGO)或结节状,并对比评估。结果 83.3%的IFD患者和92.5%的细菌性肺炎患者出现实变。IFD的多灶性非节段性实变(48%)多于细菌性肺炎(22.6%;P<0.05)。细菌性肺炎节段性或亚节段性实变发生率(43.4%)明显高于IFD(7.8%;P<0.01)。GGO和结节在IFD中比细菌性肺炎更常见(分别为60.8%比24.5%和54.9%比15.1%,P均<0.05)。实变合并GGO或结节,或同时合并GGO和结节,IFD多于细菌性肺炎(均P<0.05)。在IFD和细菌性肺炎中,有晕征的结节(n=23)分别占22.5%和3.8%。合并RHS的结节仅见于IFD,空洞结节在IFD和细菌性肺炎中的出现率分别为11.8%和1.9%。结论 实变+GGO+结节或实变+结节是诊断IFD的有效方法。更多还原

【Abstract】 Objective To evaluate the comparative value of high-resolution CT in invasive fungal disease of the lung(IFD) and bacterial pneumonia. Methods CT findings of 208 cases with IFD(n=102) or bacterial pneumonia(n=106) were retrospectively analyzed. Pulmonary shadows were classified as solid, ground glass shadows(GGO), or nodules, and the presence of ground glass halos, anti-halos signs(RHS), and voids(crescent or non-crescent) around the nodules were recorded. Results 83.3% of IFD patients and 92.5% of bacterial pneumonia patients had realistic changes. Multifocal nonsegmental consolidation was more common in IFD(48%) than bacterial pneumonia(22.6%; P<0.05). The incidence of segmental or subsegmental consolidation in bacterial pneumonia(43.4%) was significantly higher than that of IFD(7.8%; P<0.01).GGO and nodules were more common in IFD than bacterial pneumonia(60.8% vs. 24.5% and 54.9% vs. 15.1%,respectively, P<0.05). Consolidation with GGO or nodule, or both, had more IFD than bacterial pneumonia(all P<0.05). In IFD and bacterial pneumonia, nodules with halo sign(n=23) accounted for 22.5% and 3.8%, respectively. Nodules associated with RHS were only found in IFD.The incidence of caudal nodules in IFD and bacterial pneumonia was 11.8% and 1.9%,respectively. Conclusion Consolidation +GGO+ nodule or consolidation + nodule is an effective method for the diagnosis of IFD.更多还原