CAJ | 학술논문

目的分析艾滋病合并卡氏肺孢子虫肺炎影像表现,以提高对其认识,减少误诊.方法回顾性分析73例经临床确诊的艾滋病合并卡氏肺孢子虫肺炎患者的胸部X线及CT影像学表现.结果73例艾滋病合并卡氏肺孢子虫肺炎患者的影像表现可分为四型：Ⅰ型：X线及CT表现为双肺弥漫性云雾状、树枝挂霜样、磨玻璃样阴影,呈非对称性、非均匀性随机分布,磨玻璃影内可见肺血管和明显的支气管充气征,50例占68.4%；Ⅱ型：磨玻璃影合并肺气囊12例占16.4%；Ⅲ型、以斑片型或合并斑片型7例占9.6%,表现以亚段或肺段为主的斑片肺泡实变影；Ⅳ型、以线条状及网状影像表现的肺间质影和斑片影以及混合存在的阴影4例占5.5%.结论艾滋病卡氏肺孢虫肺炎影像学表现具有一定特征性,具有Ⅰ型、Ⅱ型影像特征及临床有HIV感染的可以提示诊断.反之,要提示临床做进一步的HIV及卡氏肺包子虫肺炎等方面的检查.
목적분석애자병합병잡씨폐포자충폐염영상표현,이제고대기인식,감소오진.방법회고성분석73례경림상학진적애자병합병잡씨폐포자충폐염환자적흉부X선급CT영상학표현.결과73례애자병합병잡씨폐포자충폐염환자적영상표현가분위사형：Ⅰ형：X선급CT표현위쌍폐미만성운무상、수지괘상양、마파리양음영,정비대칭성、비균균성수궤분포,마파리영내가견폐혈관화명현적지기관충기정,50례점68.4%；Ⅱ형：마파리영합병폐기낭12례점16.4%；Ⅲ형、이반편형혹합병반편형7례점9.6%,표현이아단혹폐단위주적반편폐포실변영；Ⅳ형、이선조상급망상영상표현적폐간질영화반편영이급혼합존재적음영4례점5.5%.결론애자병잡씨폐포충폐염영상학표현구유일정특정성,구유Ⅰ형、Ⅱ형영상특정급림상유HIV감염적가이제시진단.반지,요제시림상주진일보적HIV급잡씨폐포자충폐염등방면적검사.
Objective To improve the diagnose capability and reduce misdiagnosis by the close radiographic image analysis of 73 cases AIDS patients complicated with Pneumocystis carinii pneumonia. Methods To review the chest X-ray and/or CT of 73 cases AIDS patients complicated with Pneumocystis carinii pneumonia which had been make definite diagnosis. Results The radiographic features of that 73 cases can be divided into four types. In the typeⅠ, the chest X-ray or CT of 50 cases(68.4%)shows diffuse cotton-like、miliary pattern or ground-glass shadowing,and the distribution of those shadowing are asymmetric and stochastic, the pulmonary vascular and obvious aerial bronchogram can be seen in the ground-glass shadow;In the type Ⅱ,12 cases(16.4%) shows ground-glass opacity combined with lung air sac; In the type Ⅲ, seven cases (9.6%) shows the subsegmental or pulmonary segments had patchy consolidation shadow; In the type Ⅳ, four cases (5.5%) shows the pulmonary interstitial had contour-like or reticular-like shadow.Conclusions The radiograph had some characteristic features in the Pneumocystis carinii pneumonia. It can make a diagnosis if the radiograph has the typeⅠand/or typeⅡabnormal appearance on the basis of clinical HIV infection, otherwise further tests are needed.