人民卫生出版社系列期刊
ISSN 2096-2738 CN 11-9370/R

中国科技核心期刊(中国科技论文统计源期刊)
2020《中国学术期刊影响因子年报》统计源期刊

新发传染病电子杂志 ›› 2018, Vol. 3 ›› Issue (1): 34-36.

• 论著 • 上一篇    下一篇

非活动性肺结核合并肺曲霉菌感染的临床影像分析

郑广平1, 张倩倩2, 谭卫国3, 邓群益1, 陈培芬1, 苏冬娜4, 余卫业3, 吴诗品4, 陆普选3   

  1. 1.深圳市第三人民医院,广东 深圳 518112;
    2.河南省周口市中心医院,河南 周口 466000;
    3.深圳市慢性病防治中心,广东 深圳 518020;
    4.深圳市人民医院,广东 深圳 518020
  • 收稿日期:2018-01-22 出版日期:2018-02-28 发布日期:2020-06-29
  • 通讯作者: 陆普选,Email:lupuxuan@126.com
  • 基金资助:
    北京市医院管理局临床医学发展专项经费资助(扬帆计划)(ZYLX201511); 深圳市知识创新计划重点项目(JCYJ20150402111430659); 深圳市龙岗区科技发展资金医疗卫生(扶持类)重点项目(YLWS20150507112153616)

Clinical imaging analysis of inactive tuberculosis complicated by pulmonary aspergillosis

ZHENG Guang-ping1, ZHANG Qian-qian2, TAN Wei-guo3, DENG Qun-yi1, CHEN Pei-fen1, SU Dong-na4, YU Wei-ye3, WU Shi-pin4, LU Pu-xuan3   

  1. 1. Shenzhen Third People's Hospital, Guangdong Shenzhen 518112, China;
    2. Henan Zhoukou Central Hospital, Henan Zhoukou 466000, China;
    3. Shenzhen chronic disease prevention center, Guangdong Shenzhen 518020, China;
    4. Shenzhen People's Hospital, Guangdong Shenzhen 518020, China
  • Received:2018-01-22 Online:2018-02-28 Published:2020-06-29

摘要: 目的 探讨非活动性肺结核合并肺曲霉菌感染的临床影像表现,为临床早期诊断提供依据。方法 收集20例(男14例,女6例)非活动性肺结核合并肺曲霉菌感染病例,分析其临床及CT影像学资料。结果 20例中肺结核病史最短9个月,最长31年,平均时间10.6年,临床表现以咳嗽、咳痰、咳血为主。肺曲霉球13例, 慢性坏死性肺曲霉病 4例, 慢性空洞型曲霉病2例, 慢性纤维化性肺曲霉病1例。发病部位以双肺上叶尖后段、下叶背段为主,基本与肺结核一致,影像表现为单发或多发病灶密度不均匀团块影、空洞影、新月形气体影,同时肺内可见纤维索条影等陈旧性肺结核病灶。结论 非活动肺结核合并肺曲霉菌感染,60%在肺结核感染4年后确诊,且以肺曲霉球居多。CT主要表现为两肺上叶密度不均匀团块形、新月形气体影,同时伴有纤维条索影等陈旧性结核病灶改变。

关键词: 肺结核, 肺曲霉病, CT

Abstract: Objective To investigate the imaging findings of non-active pulmonary tuberculosis complicated by pulmonary fungal infection, and to provide evidence for its early diagnosis. Methods A total of 20 cases were collected based on the recruitment criteria, including 14 males and 6 females. Their clinical imaging data were retrospectively analyzed. Results The history of pulmonary tuberculosis ranged from 9 months to 31 years, with a mean of 10.6 years. The presenting symptoms included cough, expectoration and hemoptysis. As for pulmonary aspergillosis, 13 cases were diagnosed with aspergilloma; 4 cases with chronic necrotizing pulmonary aspergillosis; 2 cases with chronic cavitary aspergillosis and 1 case with chronic fibrosis of pulmonary aspergillosis. The lesions of pulmonary aspergillosis were commonly located at the apicoposterior segment of the upper lobes of both lungs, dorsal segment of the lower lobes of both lungs, which were consistent with that of pulmonary tuberculosis. The imaging demonstrations included singular or multiple heterogenous mass opacity, cavitary opacity, and air crescent opacity. Meanwhile, fibrous cords like opacity of old tuberculosis lesions were demonstrated in the lungs. Conclusion As for inactive pulmonary tuberculosis complicated by pulmonary aspergillosis, 60% of the cases are definitely diagnosed at 4 years after tuberculosis infection. Aspergilloma is the most common pulmonary aspergillosis complicating inactive pulmonary tuberculosis. CT scan demonstrations include heterogenous mass opacity and air crescent opacity at upper lobes of both lungs, occasionally accompanied by fibrous cords like opacity of old tuberculosis lesions.

Key words: Pulmonary tuberculosis, Pulmonary aspergillosis, CT