摘要
目的探讨儿童白血病继发肺部真菌感染的CT表现特点及诊断价值。方法回顾性分析我院血液科36例白血病继发肺部真菌感染患儿临床资料,所有患儿均进行CT检查,分析其病灶CT表现特点。结果36例白血病继发肺部真菌感染患儿中曲霉菌、白色念珠菌、卡氏肺孢子菌、隐球菌、毛霉菌感染者分别为14例、10例、6例、3例、3例。CT表现:(1)曲霉菌感染:病灶呈结节样实变,多见于胸膜下,且以多发、散在、多形态、双侧肺部病变为主,晕征、空气新月征多见,部分可见支气管血管束、胸膜粘连;(2)白色念珠菌感染:病灶呈结节样、斑片状、片状样、索条状实变、磨玻璃样密度或粟粒样且多并存,以多发、双侧肺部病变为主,少数可见晕征、胸腔积液;(3)卡氏肺孢子菌感染:呈弥漫性磨玻璃密度双侧肺部病变,病灶内可见索条影或粟粒样;少数可见胸膜粘连、纵膈淋巴结增大;(4)隐球菌感染:病灶位于胸膜下且为多发病灶,呈结节样实变,部分可见不规则空洞、晕征、胸膜粘连;⑤毛霉菌感染:病灶呈双侧弥漫性肺病变,部分可见支气管血管束、纵膈淋巴结增大。CT诊断准确率为88.89%。结论不同菌株感染的白血病继发肺部真菌感染患儿CT表现特点不同,CT具有重要诊断价值。
Objective To investigate CT findings of pulmonary fungal infection in children with leukemia and its diagnostic value.Methods The clinical data of 36 children with pulmonary fungal infection secondary to leukemia in hematology department of the hospital were retrospectively analyzed.All children completed CT examination and CT findings were analyzed.Results In this study,there were 14,10,6,3 and 3 children infected with Aspergillus,Candida albicans,Pneumocystis carinii,Cryptococcus and Mucor.CT findings were as follows:(1)For Aspergillus infection,the lesions were nodular consolidation which was more common under the pleura,and they mainly were multiple,scattered,polymorphic,bilateral lung lesions.Halo sign and air meniscus sign were common,and some showed bronchial vascular bundles and pleural adhesions.(2)For Candida albicans infection,lesions showed nodular,patchy,sheet and linear consolidation,ground-glass opacity or miliary shape.Most were co-existent,multiple and bilateral lung lesions.Few showed halo signs and pleural effusion.(3)For Pneumocystis carinii infection,lesions were diffuse bilateral lung lesions with ground-glass opacity,and there were linear or miliary shadows inside.Few showed pleural adhesions and enlarged mediastinal lymph nodes.(4)For Cryptococcus infection,the lesions were located under the pleura and were multiple lesions.Most were nodular consolidation,and some showed irregular cavities,halo signs and pleura adhesion.(5)For Mucor infection,the lesions were diffuse bilateral lung lesions,and some showed bronchial vascular bundles and enlarged mediastinal lymph nodes.The diagnostic accuracy rate of CT was 88.89%.Conclusion Children with pulmonary fungal infection secondary to leukemia infected by different strains have different CT findings.CT is of high diagnostic value.
作者
赵凤华
谢坚
胡陶
ZHAO Feng-hua;XIE Jian;HU Tao(Department of Pediatric Hematology,Mianyang Central Hospital,Mianyang 621000,Sichuan Province,China)
出处
《中国CT和MRI杂志》
2022年第10期31-33,共3页
Chinese Journal of CT and MRI
关键词
儿童白血病
肺部真菌感染
CT图像
诊断价值
Children With Leukemia
Pulmonary Fungal Infection
CT Image
Diagnostic Value
