摘要
目的探讨电子计算机断层扫描(CT)/磁共振成像(MRI)对儿童白血病合并真菌感染的早期诊断价值。方法收集2017年1月至2018年6月白血病合并真菌感染儿童共69例,其中实验室检查确诊真菌感染23例,实验室检查阴性、抗真菌治疗有效46例,分别行CT或MRI检查。结果胸部CT表现:结节影57例,晕征21例,空洞影17例,空气新月征5例,楔形实变影3例,其中23例同时合并2~3种特征性表现;腹部CT表现:肝脏斑片状或结节状低密度影9例,脾脏低密度结节影2例,肾脏低密度影2例;鼻部CT表现:真菌性鼻窦炎1例,鼻中隔及上颌骨破坏1例;颅脑MRI表现:脑脓肿5例,合并脑梗塞、梗阻性脑积水1例。结论儿童白血病合并真菌感染具有典型影像学表现,CT/MRI有助于临床早期诊断及治疗,从而改善白血病患儿预后。
Objective To investigate value of computed tomography(CT)/magnetic resonance imaging(MRI) for early diagnosis of childhood leukemia accompanying with fungal infection. Methods 69 children with leukemia accompanying with fungal infection in our hospital from January 2017 to June 2018 were collected,among them 23 patients were determined having fungal infection by laboratory examination and 46 patients had negative laboratory examination result but their antifungal treatment was effective. All the patients received CT or MRI examination respectively. Results Chest CT findings were as follows:nodule shadow in 57 cases,halo sign in 21 cases,cavity shadow in 17 cases,air crescent sign in 5 cases,wedge-shaped consolidation shadow in 3 cases,and two or three characteristic manifestations mentioned above in 23 cases. Abdominal CT findings:liver patchy or nodular low-density shadow in 9 cases,spleen low-density nodule shadow in 2 cases,kidney low-density shadow in 2 cases. CT of the nose showed fungal sinusitis in 1 case,nasal septum and maxillary destruction in 1 case. Brain MRI findings:brain abscess in 5 cases,cerebral infarction and obstructive hydrocephalus in 1 case. Conclusion Childhood leukemia accompanying fungal infection has typical imaging appearances,CT/MRI is helpful for early clinical diagnosis and treatment to improve prognosis of these children with leukemia.
作者
白慧萍
蒋昊翔
王冬
陈超
侯欣
BAI Huiping;JIANG Haoxiang;WANG Dong;CHEN Chao;HOU Xin(Department of Imaging,Xi\an Municipal Children\s Hospital,Shaanxi Xi\an 710002,China)
出处
《中国妇幼健康研究》
2020年第5期640-644,共5页
Chinese Journal of Woman and Child Health Research
基金
西安市卫计委课题(编号:J201701005)。
关键词
白血病
真菌感染
早期诊断
影像研究
leukemia
fungal infection
early diagnosis
imaging study
