CT在肺部真菌感染诊断与鉴别中的应用效果
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摘要
目的探讨CT在肺部真菌感染诊断与鉴别中的应用效果。方法选择2017年1月至2018年7月我院心胸科收治的40例肺部真菌感染(感染组)、40例肺结核(肺结核组)及40例肺癌(肺癌组)患者为研究对象,所有患者均进行CT、X线检查。分析总结两种检查方式对肺部真菌感染的鉴别诊断效果及不同肺部疾病的CT影像学特征。结果 40例肺部真菌感染患者病原菌中曲霉菌占比最大(40.0%),其次为隐球菌(30.0%)、白色念珠菌(17.5%)、包浆菌(10.0%)及毛霉菌(2.5%)。CT检查肺部真菌感染的灵敏度、特异度和准确率均显著高于X线检查(P<0.05)。肿块型、斑片结节型患者占比显著高于实变型患者(P<0.05)。感染组患者深分叶征、浅分叶征、长毛刺征、短毛刺征、支气管充气征、晕征检出率显著高于肺结核组,钙化、卫星灶、液化及坏死、淋巴结肿大检出率显著低于肺结核组(P<0.05)。感染组患者深分叶征、长毛刺征、支气管充气征、晕征检出率显著高于肺癌组,凹陷征、空泡征、液化及坏死、淋巴结肿大检出率显著低于肺癌组(P<0.05)。结论肺部真菌感染患者实施CT诊断的准确率高,可有效辅助疾病鉴别诊断。
Objective To investigate the application effect of CT in the diagnosis and differentiate of pulmonary fungal infection. Methods Forty patients with pulmonary fungal infection(infection group), 40 patients with pulmonary tuberculosis(pulmonary tuberculosis group) and 40 patients with lung cancer(lung cancer group) in the cardiothoracic department of our hospital from January 2017 to July 2018 were selected. All patients underwent CT and X-ray examination. The effect of the differentiate and diagnosis of pulmonary fungal infection by two methods of examination and CT imaging characteristics of different pulmonary diseases were analyzed and summarized. Results Among 40 patients with pulmonary fungal infection,Aspergillus accounted for the largest proportion(40.0%), followed by Cryptococcus(30.0%), Candida albicans(17.5%),Encapsulated fungi(10.0%) and Mucor(2.5%). The sensitivity, specificity and accuracy of CT examination for pulmonary fungal infection were significantly higher than those of the X-ray examination(P<0.05). The proportions of patients with mass type and patchy nodule type were significantly higher than that of patients with solid type(P<0.05). The detection rates of deep lobulation sign, shallow lobulation sign, long burr sign, short burr sign, bronchial inflation sign and halo sign in the infection group were significantly higher than those in the pulmonary tuberculosis group, and the detection rates of calcification, satellite focus, liquefaction and necrosis, lymphadenopathy were significantly lower than those in the pulmonary tuberculosis group(P<0.05). The detection rates of deep lobulation sign, long burr sign, bronchial inflation sign and halo sign in the infection group were significantly higher than those in the lung cancer group, while the detection rates of depressed sign, vacuole sign, liquefaction and necrosis, lymphadenopathy were significantly lower than those in the lung cancer group(P <0.05). Conclusion The CT diagnosis of pulmonary fungal infections has high accuracy, which can effectively assist the differential diagnosis of diseases.
Objective To investigate the application effect of CT in the diagnosis and differentiate of pulmonary fungal infection. Methods Forty patients with pulmonary fungal infection(infection group), 40 patients with pulmonary tuberculosis(pulmonary tuberculosis group) and 40 patients with lung cancer(lung cancer group) in the cardiothoracic department of our hospital from January 2017 to July 2018 were selected. All patients underwent CT and X-ray examination. The effect of the differentiate and diagnosis of pulmonary fungal infection by two methods of examination and CT imaging characteristics of different pulmonary diseases were analyzed and summarized. Results Among 40 patients with pulmonary fungal infection,Aspergillus accounted for the largest proportion(40.0%), followed by Cryptococcus(30.0%), Candida albicans(17.5%),Encapsulated fungi(10.0%) and Mucor(2.5%). The sensitivity, specificity and accuracy of CT examination for pulmonary fungal infection were significantly higher than those of the X-ray examination(P<0.05). The proportions of patients with mass type and patchy nodule type were significantly higher than that of patients with solid type(P<0.05). The detection rates of deep lobulation sign, shallow lobulation sign, long burr sign, short burr sign, bronchial inflation sign and halo sign in the infection group were significantly higher than those in the pulmonary tuberculosis group, and the detection rates of calcification, satellite focus, liquefaction and necrosis, lymphadenopathy were significantly lower than those in the pulmonary tuberculosis group(P<0.05). The detection rates of deep lobulation sign, long burr sign, bronchial inflation sign and halo sign in the infection group were significantly higher than those in the lung cancer group, while the detection rates of depressed sign, vacuole sign, liquefaction and necrosis, lymphadenopathy were significantly lower than those in the lung cancer group(P <0.05). Conclusion The CT diagnosis of pulmonary fungal infections has high accuracy, which can effectively assist the differential diagnosis of diseases.
引文
[1]诸绍锋,卢增新,王亚琴,等.CT在诊断与鉴别肺部真菌感染中的临床价值分析[J].中华医院感染学杂志,2016,26(18):4141-4143.
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[4]梁俊生,曾仲刚,朱刚明,等.肺真菌感染的CT表现及鉴别诊断[J].中国CT和MRI杂志,2015,13(7):28-32.
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[7]李先明,周建辉,吴兆生,等.MSCT在重症肝病患者肺部真菌感染的诊断评价[J].中国急救医学,2016,36(z2):26-27.
[8]郑新成,赵志新,金莉莉,等.肺部真菌感染的CT影像学诊断分析[J].中华医院感染学杂志,2016,26(17):3942-3944.
[9]曾瑞敏,许崇永,杨忠福,等.肿块型肺部真菌感染的CT诊断分析[J].中华医院感染学杂志,2016,26(4):777-779.
[10]过丽芳,贺伟,王仁贵,等.肺结核并发肺部真菌感染的CT表现特征分析[J].中国防痨杂志,2017,39(6):570-575.
[11]孙继锋,陈殿森,李扬,等.肺部真菌感染的CT表现[J].中国中西医结合影像学杂志,2016,14(1):84-85.
[12]苏卫年,王加伟.多排螺旋CT诊断肺部真菌感染的临床价值分析[J].医学影像学杂志,2016,26(7):1324-1326.
[13]丛黎,杨传彬,邵龙,等.CT对肺真菌感染的诊断价值及误诊因素分析[J].中国中西医结合影像学杂志,2017,15(5):610-612.
[2]徐海东,张玉琴,董海波,等.CT与X线对肺部真菌感染患者的诊断价值[J].中华医院感染学杂志,2015,25(18):4209-4210,4213.
[3]陈晶露.CT在诊断与鉴别肺部真菌感染中的临床价值分析[J].世界复合医学,2016,2(2):51-53.
[4]梁俊生,曾仲刚,朱刚明,等.肺真菌感染的CT表现及鉴别诊断[J].中国CT和MRI杂志,2015,13(7):28-32.
[5]李建华.肺部真菌感染的CT诊断及鉴别[J].中国保健营养,2017,27(34):87-88.
[6]王春宇.CT检查对肺部真菌感染患者的临床诊断价值[J].中国民康医学,2016,28(5):52-53.
[7]李先明,周建辉,吴兆生,等.MSCT在重症肝病患者肺部真菌感染的诊断评价[J].中国急救医学,2016,36(z2):26-27.
[8]郑新成,赵志新,金莉莉,等.肺部真菌感染的CT影像学诊断分析[J].中华医院感染学杂志,2016,26(17):3942-3944.
[9]曾瑞敏,许崇永,杨忠福,等.肿块型肺部真菌感染的CT诊断分析[J].中华医院感染学杂志,2016,26(4):777-779.
[10]过丽芳,贺伟,王仁贵,等.肺结核并发肺部真菌感染的CT表现特征分析[J].中国防痨杂志,2017,39(6):570-575.
[11]孙继锋,陈殿森,李扬,等.肺部真菌感染的CT表现[J].中国中西医结合影像学杂志,2016,14(1):84-85.
[12]苏卫年,王加伟.多排螺旋CT诊断肺部真菌感染的临床价值分析[J].医学影像学杂志,2016,26(7):1324-1326.
[13]丛黎,杨传彬,邵龙,等.CT对肺真菌感染的诊断价值及误诊因素分析[J].中国中西医结合影像学杂志,2017,15(5):610-612.