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目的研究肺真菌病的X线及CT表现,探讨其影像诊断要点。方法回顾性分析经病理及临床证实的21例肺真菌病的影像学表现。结果肺真菌病的影像学表现主要有肺炎性实变12例,坏死伴空洞12例及曲菌球6例,结节病灶及肿块12例,毛玻璃样阴影16例,肺门、纵隔淋巴结肿大2例,胸膜炎及胸腔积液8例。病理组织学及真菌培养结果为曲霉菌13例,白色念珠菌5例,隐球菌3例。结论肺真菌病的影像学表现复杂多变,是多发、多种形态的病变并存。出现曲菌球者可明确肺曲菌病的诊断,当出现弥漫混合病变(实变、结节病灶及肿块)、绕有“晕征”的结节时应考虑是否有真菌感染,并结合其临床可提高诊断率。
Objective To study the X-ray and CT findings of pulmonary fungal diseases and discuss the main points of imaging diagnosis. Methods The imaging findings of 21 pulmonary fungal diseases confirmed by pathology and clinic were retrospectively analyzed. Results The main imaging features of pulmonary mycosis were pneumonia consolidation in 12 cases, necrosis with empty cavity in 12 cases, aspergilloma in 6 cases, nodular lesions and mass in 12 cases, ground glass-like shadow in 16 cases, hilar and mediastinal lymph nodes 2 cases, pleurisy and pleural effusion in 8 cases. Histopathology and fungal culture results for Aspergillus 13 cases, Candida albicans 5 cases, Cryptococcus 3 cases. Conclusions The imaging findings of pulmonary mycosis are complex and changeable. It is multiple and multiple forms of lesions coexist. The presence of aspergillum can confirm the diagnosis of pulmonary aspergillosis, consider the presence of fungal infections when there are diffuse mixed lesions (consolidation, nodular lesions and lumps), nodules around the “halo sign” and Combined with its clinical diagnosis can be increased.