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目的探讨艾滋病合并马尔尼菲青霉菌感染的胸部影像学表现。方法回顾性分析36例艾滋病合并马尔尼菲青霉菌感染者的胸部 X 线片+高分辨率 CT(HRCT)表现。结果 36例患者胸片中14例出现肺内浸润性病灶或局限性肺实变(38.89%),其中单肺2例(5.56%)、双肺12例(33.33%);8例呈弥漫性分布(22.22%),10例呈网织纹理(27.78%)、9例见小结节(25.00%)、7例呈磨玻璃密度影(19.44%)、6例见粟粒样病变(16.67%)、5例见肺气囊(13.89%)、4例见胸腔积液(11.11%)、4例出现肺门及纵隔淋巴结增大(11.11%)、2例见结节状肿块影(5.56%)、心包积液及自发性气胸各1例(2.78%);36例患者 HRCT 发现32例出现肺内浸润性病灶或局限性肺实变(88.89%),其中单肺4例(11.11%)、双肺28例(77.78%);13例呈弥漫性分布(36.11%)、10例见小叶间隔增厚(27.78%)、9例见小结节(25.00%)、8例呈磨玻璃样密度影(22.22%)、9例见粟粒样病变(25.00%)、8例见肺气囊(22.22%)、13例见胸腔积液(36.11%)、21例见纵隔淋巴结增大(58.33%)、2例见结节状肿块影(5.56%),心包积液及自发性气胸各1例(2.78%)。结论艾滋病合并马尔尼菲青霉菌感染者常见的胸部影像表现为:肺内多发的浸润性病灶或局限性肺实变及磨玻璃密度影,肺门或纵隔淋巴结增大,胸腔积液,肺间质病变即网织纹理(小叶间隔增厚),粟粒样病变及肺气囊。
Objective To investigate the chest imaging features of HIV / AIDS Penicillium marneffei infection. Methods The chest X-ray and high-resolution CT (HRCT) findings of 36 HIV-infected patients with Penicillium marneffei were retrospectively analyzed. Results Of the 36 cases, 14 cases had infiltrative pulmonary infiltrates or localized pulmonary consolidation (38.89%) in 2 cases, of which 2 cases were single lungs (5.56%) and 12 cases were lungs (33.33%); 8 cases were diffuse (22.22%), 10 with reticular texture (27.78%), 9 with small nodules (25.00%), 7 with ground glass density (19.44%) and 6 with miliary lesions (16.67% (13.89%) in 5 cases, pleural effusion in 4 cases (11.11%), enlarged hilar and mediastinal lymph nodes (11.11%) in 4 cases, nodular mass (5.56%) in 2 cases, Pericardial effusion and spontaneous pneumothorax in 1 case (2.78%). Thirty-six patients had pulmonary infiltrates or localized pulmonary lesions in 88 cases (88.89%), including 4 cases of single lung (11.11%), Thirty-eight cases were diffusely distributed (36.11%), 10 cases were interlobular septal thickening (27.78%), 9 cases were small nodules (25.00%), 8 cases were milled glass-like density (22.22%), 9 cases of miliary lesions (25.00%), 8 cases of pulmonary balloon (22.22%), 13 cases of pleural effusion (36.11%), 21 cases of mediastinal lymph nodes (58.33% For example, see the nodular mass (5.56%), pericardial effusion and spontaneous pneumothorax in 1 case (2.78%). Conclusions The common chest images of AIDS patients with Penicillium marneffei infection are as follows: multiple invasive lesions in the lung or limited pulmonary solidification and ground glass density, increased hilar or mediastinal lymph nodes, pleural effusion, Texture lesions that reticulate texture (interlobular septal thickening), miliary lesions and lung balloon.