CAJ | 학술논문

目的：探讨肺真菌感染的CT表现及与肺癌、肺结核的鉴别诊断。方法搜集36例经病理证实的肺真菌感染的64层CT检查资料，同时随机搜集同期肺癌、肺结核各30例患者的CT资料作为对照组。对研究组、对照组的影像学资料进行综合分析，并分别比较两者CT征象有无统计学差异。结果36例肺真菌感染患者中，双肺病灶26例，斑片、结节型15例，肿块型13例，实变型8例；主要征象包括浅分叶征、深分叶、支气管充气征、长毛刺、短毛刺、空泡、晕征等；肺癌组中深分叶、支气管充气征、长毛刺、晕征出现频数明显较研究组少，而凹陷征、空泡征和纵隔淋巴结肿大明显较多(P＜0.05)；结核组中浅分叶、深分叶、支气管充气征、长毛刺、短毛刺和晕征出现频数明显较研究组少，而卫星灶、钙化、淋巴结肿大明显较多(P＜0.05)。增强扫描，肺真菌感染病灶CT值增加值与两对照组比较有统计学差异(t1=5.62，P＜0.05 t2=5.71，P＜0.05)。结论肺部真菌感染影像学表现具有多样性，出现典型曲霉菌球的“新月征”可明确肺曲霉菌病的诊断，若出现磨玻璃影及“晕征”是真菌感染病灶较具特征性的表现；此外，双肺多发病灶，征象多样，且变化快，提示真菌感染可能。
목적：탐토폐진균감염적CT표현급여폐암、폐결핵적감별진단。방법수집36례경병리증실적폐진균감염적64층CT검사자료，동시수궤수집동기폐암、폐결핵각30례환자적CT자료작위대조조。대연구조、대조조적영상학자료진행종합분석，병분별비교량자CT정상유무통계학차이。결과36례폐진균감염환자중，쌍폐병조26례，반편、결절형15례，종괴형13례，실변형8례；주요정상포괄천분협정、심분협、지기관충기정、장모자、단모자、공포、훈정등；폐암조중심분협、지기관충기정、장모자、훈정출현빈수명현교연구조소，이요함정、공포정화종격림파결종대명현교다(P＜0.05)；결핵조중천분협、심분협、지기관충기정、장모자、단모자화훈정출현빈수명현교연구조소，이위성조、개화、림파결종대명현교다(P＜0.05)。증강소묘，폐진균감염병조CT치증가치여량대조조비교유통계학차이(t1=5.62，P＜0.05 t2=5.71，P＜0.05)。결론폐부진균감염영상학표현구유다양성，출현전형곡매균구적“신월정”가명학폐곡매균병적진단，약출현마파리영급“훈정”시진균감염병조교구특정성적표현；차외，쌍폐다발병조，정상다양，차변화쾌，제시진균감염가능。
Objective To discuss the CT manifestation of pulmonary fungal infection, and the differential diagnosis of lung cancer and tuberculosis. Methods Collecting 36 cases confirmed by pathology, CT examination data of 64 layer of pulmonary fungal infection, at the same time random collection period lung cancer and tuberculosis all CT data of 30 patients as control group. Analyzing the imaging data of the team, the control group, and compare the two respectively CT signs Presence of Statistical differences. Results 36 cases of pulmonary fungal infection in patients, mostly in the stove double lung disease 26 cases, patch, nodular type 15 cases, tumor type 13 cases, solid variant 8 cases;The Mainly signs include shallow lobulation,deep lobulated, the air-filled bronchi, long burr, short burr, cavitation and halo sign;In lung cancer group deep lobulated, air-filled bronchi, abnormal bronchial beam, long burr, halo sign appear frequency relatively less research obviously, and sag,cavitation,mediastinal lymph nodes enlargement, more obvious than the team between statistical differences (P<0.05);TB group shallow lobulation sign,deep lobulated sign, air-filled bronchi, abnormal bronchial beam, short burr,long burr, and halo sign appear frequency relatively less research group obviously, and satellite stove, calcification, lymph nodes are enlarged, more obvious than team between statistical differences (P<0.05). Enhanced scan, the CT added value of pulmonary fungal infection was statistical difference with the control group (t1=5.62, P<0.05 t2=5.71, P<0.05). Conclusion Pulmonary fungal infection imaging findings with diversity,"crescent sign" appears typical aspergillus ball can clear the diagnosis of pulmonary aspergillosis, if appear ground glass shadow and"halo sign"is the expression of the fungal infection lesions are more characteristic;In addition, the double lung multiple lesions, signs, and change quickly, suggest possible fungal infection.