CAJ | 학술논문

目的：探讨血管侵袭性肺曲霉菌病的 CT 表现。方法回顾性分析52例经病理或临床证实为血管 IPA 的CT 表现。结果多发35例；以双肺外周带分布为主39例；病灶形态为结节或肿块38例；伴有晕征21例，其中15例发生于血液系统恶性肿瘤患者；中心低密度征13例；反晕征5例；空气半月征或空洞28例，其中49个（67％，49／73）病灶的空气半月征或空洞位于近肺门位置；9例增强扫描病例出现环形强化。17例随访患者中，7例空气半月征、4例空洞分别出现在晕征之后的第2、4周。结论血管 IPA 的 CT 常表现为双肺外周带多发结节或肿块影，常伴晕征或空气半月征或空洞，后二者多位于病变肺门侧；CT 动态观察诊断意义较大；肿块结节内中心低密度征，反晕征以及增强扫描环形强化有助于诊断。
목적：탐토혈관침습성폐곡매균병적 CT 표현。방법회고성분석52례경병리혹림상증실위혈관 IPA 적CT 표현。결과다발35례；이쌍폐외주대분포위주39례；병조형태위결절혹종괴38례；반유훈정21례，기중15례발생우혈액계통악성종류환자；중심저밀도정13례；반훈정5례；공기반월정혹공동28례，기중49개（67％，49／73）병조적공기반월정혹공동위우근폐문위치；9례증강소묘병례출현배형강화。17례수방환자중，7례공기반월정、4례공동분별출현재훈정지후적제2、4주。결론혈관 IPA 적 CT 상표현위쌍폐외주대다발결절혹종괴영，상반훈정혹공기반월정혹공동，후이자다위우병변폐문측；CT 동태관찰진단의의교대；종괴결절내중심저밀도정，반훈정이급증강소묘배형강화유조우진단。
Objective To analyze the MSCT performance of pulmonary angioinvasive aspergillosis .Methods CT ap‐pearances of 52 pulmonary angioinvasive aspergillosis patients proved by pathology or clinic were retrospectively analyzed . Results Multiple lesions (35 cases) mainly distributed in the peripheral areas of lung field (39 cases) .The shape of the lesions were nodules or tumors (38 cases) accompanied with halo sign (21 cases) ,15 cases of these 21 cases were hap‐pened in patients with hematologic malignancies .There were hypodense sign (13 cases) ,reversed halo sign (5 cases) ,air crescent sign or cavities (28 cases) ,and 49 (67% ,49/73)crescent sign or cavities .Among these 28 cases located near the hilar of the lesions ,9 enhanced cases presented border strengthen .There were totally 17 revisited cases ,presenting air crescent sign (7 cases) and cavities (4 cases) respectively performed after 2 and 4 weeks of halo signs .Conclusion Pul‐monary angioinvasive aspergillosis usually presented multiple nodules or tumors in the peripheral areas of lung field ,usual‐ly accompanied with halo sign or air crescent sign or cavities .The two latter signs usually located near the hilar of the le‐sions ,CT dynamic follow‐up has a diagnostic significance .The hypodense sign ,reversed halo sign and border strengthen in enhanced cases may help to diagnosis .