卡氏肺囊虫肺炎非典型CT表现回顾分析
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| 时间：2009-02-13 18:18:15 来源： 作者： |
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Retrospective Analysis of the Aptical CT Manifestation of Pneumocystis Carinii
Luo Ying, Chen Shouming, He Zhibing, Zhao Baichuan, Zuo Bin, Ma Fangwei, Li Guangji, the Affliated Hospital to Panzhihua University, Panzhihua City, Sichuan Province 617000
Abstract Objective To analyze the aptical CT manifestation of pneumocystis carinii of the patients with AIDS retrospectively. Methods A retrospective analysis was made to the CT images of 4 confirmed cases with AIDS complicated with pneumocystis carinii.Results 2 cases showed dotted patchy and nodular opacities in both lungs, some of which had mass-like changes, the peripheral zones of lungs were clearly shown while the edges were not; there were no obvious abnormities in hilus and mediastinum and no obvious changes of lung strome; 1 case showed consolidation in the right lower lung and 1 case showed dotter fibrosis in the lung field and patchy shadow close to the right hilum; the CT manifestations of the 4 cases were significantly difderent from those of the typitcal manifestation of pneumocystis carinii.Conclusions The CT manifestation of the cases with AIDS and pneumocystis carinii are complicated and various and careful analysis should be made when diagnozing in consideration of other correlated examinations.
Keywords pneumocystis carinii pneumonia tomography
卡氏肺囊虫肺炎（pneumocystis carinii pneumonia，PCP）是艾滋病（AIDS）患者最常见和最严重的机遇性肺炎，约占艾滋病患者肺部感染性疾病的60%85%，是艾滋病患者主要致死原因之一［1］。现就近期诊断的4例非典型CT表现的艾滋病合并卡氏肺囊虫肺炎的病例作回顾性分析，同时复习相关文献，加深和提高对艾滋病机遇性肺炎CT诊断的认识。
1 资料与方法
1.1 一般资料 收集2004～2008年我院门诊及住院诊断的4例艾滋病合并卡氏肺囊肿肺炎病例。其中男性3例，女性1例，年龄37～54岁。平均45岁。其中1例女患者，54岁，干咳，无痰近1月，偶有低热。无不洁性生活史，无献血及输血史。曾在外院抗感染治疗无效来我院就诊。其余3例均是我院住院病人，因间断咳嗽或发热住院，经正规抗炎治疗10～14天。进行肺部CT检查。
1.2 检查设备 西门子Somatom Balance单层螺旋CT机行常规胸部平扫，层厚8mm。
2 结果
4例患者均经特定医疗机构病理证实为：艾滋病合并卡氏肺囊虫肺炎。其中2例表现为双肺散在结节影，大小不等，直径1最大约3.0cm，以肺野外带明显，病灶边缘稍模糊，可见血管影达病灶边缘，部分病灶内可见含气支气管影，有少部分病灶内可见小空洞样变。其中1例复查CT示：病变有明显进展，部分病灶融合成肿块样改变。1例病例仅见右下肺野片状实变影，部分边缘较模糊。1例病例双肺野见散在纤维化灶，右肺门区见小片状影。4例病例均无肺门淋巴结肿大及纵隔明显异常改变，肺间质改变均不明显。
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