摘要
目的探讨艾滋病患者合并肺部真菌感染的CT表现特征及与CD4+T淋巴细胞计数的相关性。方法将32例艾滋病合并肺部真菌感染的CT表现,结合临床资料以及CD4+T淋巴细胞水平(分为>100/μl、50~100/μl和≤50/μl三个区间)进行回顾分析,并行统计学检验。结果 CT表现有空洞型15例(46.9%),其中多发空洞11例,单发空洞4例,空洞周围有"晕征"者6例,出现"洞中球征"7例。团块型6例(18.8%),其中多发5例,单发1例,团块影内继发空洞3例。腺泡结节型5例(15.6%),其中局限分布2例,弥漫分布3例。浸润实变型3例(9.4%),多发1例,单发2例。弥漫混合型3例(9.4%)。合并其他影像学表现有:大片磨玻璃影3例,斑片状影、孤立结节及空洞型结节等散在分布的病灶9例,胸腔积液5例,纵隔和肺门淋巴结肿大8例。各型肺真菌感染的CD4+T淋巴细胞计数之间无显著性差异(F=2.219,P=0.094);随着CD4+T淋巴细胞减少,病变数量趋向于多发,分布范围更加广泛,病变数量及累及范围与CD4+T淋巴细胞计数有显著的相关性(χ2=7.017,P=0.023)。结论艾滋病合并肺部真菌感染的CT主要表现有空洞型、团块型、腺泡结节型、浸润实变型、弥漫混合型和合并其他影像学表现。CD4+T淋巴细胞计数与肺真菌感染的病变数量及累及范围有显著的相关性。
Objective To discuss the CT features of AIDS patients with pulmonary fungal infection and to analyze its correlation with CD4^ ＋ T cell count. Methods CT findings in 32 patients with AIDS complicated by pulmonary fungal infection were retrospectively analyzed. CD4 ^＋T lymphocyte counts were divided into three levels： 〉 100/μl, 〉 50 - 〈 100/ μl and ≤50/μl. The correlations between CT findings and CD4^ ＋ T lymphocyte counts were statistically analyzed. Results CT manifestations were as follows ： cavity （ n = 15, 46.9% ）, including multiple cavities （ n = 11 ） and single cavity （ n = 4）, the ＂halo sign＂ around the cavity （ n = 6 ）, ＂ball within hole＂ sign （ n = 7 ）. Mass type was seen in 6 cases （ 18.8% ） , of which 5 were multiple and one was single. Secondary cavity within the mass shadow was found in 3 cases. Alveolar nodular type was seen in 5 cases （ 15.6% ）, which was localized （ n = 2） or diffusely distributed （ n = 3 ）. Infiltration consolidation pattern was observed in 3 cases （9.4%） , being characterized by multiple infiltration （ n = 1 ） or solitary infiltration （n = 2）. Diffuse mixed type was seen in 3 cases （9.4%）. Other imaging manifestations included large areas of ground-glass opacity （ n = 3 ）, scattered patchy shadow, solitary nodule and cavitation of nodule （ n = 9 ）, pleural effusion （ n = 5 ）, and mediastinal and hilar lymphadenopathy （ n = 8 ）. No significant differences in CD4^ ＋ T lymphocyte count existed between different types of pulmonary fungal infection （F = 2. 219, P = 0. 094）. Along with decreased CD4 ^＋ T/ymphocytes the number of lesions tended to become multiple and the distribution of lesions became more widely. CD4 ^＋ T lymphocyte count showed a significant correlation with the lesion＇ s number and extent （Х^2 =7. 017, P = 0.023 ）. Conclusion The main CT features of AIDS complicated by pulmonary fungal infection include cavity type, mass type, acinar nodule type, infiltration consolidation type, diffuse mixed type and other imaging manifestations. A significant correlation exists between CD4^ ＋ T lymphocyte count and the lesion number as well as the extent of pulmonary fungal infection.
出处
《临床放射学杂志》
CSCD
北大核心
2014年第7期993-997,共5页
Journal of Clinical Radiology
