肺诺卡菌病胸部CT特征
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摘要
目的探讨肺诺卡菌病的胸部CT特点。方法回顾性分析经病原学培养确诊的8例肺诺卡菌病患者的胸部CT表现、临床资料。结果 8例患者中,5例为单纯肺诺卡菌病,3例为播散型肺诺卡菌病。肺部病变以斑片、实变影最为多见(n=8),其次为结节影(n=5)、空洞影(n=4)、团块影(n=2)。4例合并胸腔积液或积脓,5例肺内病灶区域胸膜增厚,3例合并纵隔、肺门淋巴结肿大,1例合并气胸、1例合并心包积液。结论肺诺卡菌病的胸部CT表现多样,常合并四肢或躯干皮肤或皮下软组织感染;当肺部病灶发展迅速,出现实变、结节、空洞、肿块等多样病灶时,应考虑肺部诺卡菌感染的可能。
Objective To explore the CT imaging features of pulmonary nocardiosis.Methods The clinical data and chest CT imaging of 8patients with pulmonary nocardiosis were retrospectively analyzed.Results In 8patients,5cases were isolated pulmonary and 3cases were lung and dissemination nocardiosis.The most common pulmonary parenchymal abnormalities were patchy or consolidation opacity(n=8),and then were nodules(n=5),cavitations(n=4),mass(n=2).Four cases combined with pleural effusion or empyema and 5cases with pleural thickening which near the lung lesions,3cases with lymphadenopathy,1case with pneumothorax,1case with pericardial effusion.Conclusion The chest CT imaging of pulmonary nocardiosis is heterogeneous,often merge pulmonary lesions with limbs or trunk skin infections.When disease of lung developes rapidly and has characteristcs of the real variable,nodules,cavitation or mass,pulmonary nocardiosis,the pulmonary nocardiosis should be considered.
Objective To explore the CT imaging features of pulmonary nocardiosis.Methods The clinical data and chest CT imaging of 8patients with pulmonary nocardiosis were retrospectively analyzed.Results In 8patients,5cases were isolated pulmonary and 3cases were lung and dissemination nocardiosis.The most common pulmonary parenchymal abnormalities were patchy or consolidation opacity(n=8),and then were nodules(n=5),cavitations(n=4),mass(n=2).Four cases combined with pleural effusion or empyema and 5cases with pleural thickening which near the lung lesions,3cases with lymphadenopathy,1case with pneumothorax,1case with pericardial effusion.Conclusion The chest CT imaging of pulmonary nocardiosis is heterogeneous,often merge pulmonary lesions with limbs or trunk skin infections.When disease of lung developes rapidly and has characteristcs of the real variable,nodules,cavitation or mass,pulmonary nocardiosis,the pulmonary nocardiosis should be considered.
引文
[1]Ambrosioni J,Lew D,Garbino J.Nocardiosis:Updated clinical review and experience at a tertiary center.Infection,2010,38(2):89-97.
[2]Khan BA,Duncan M,Reynolds J,et al.Nocardia infection in lung transplant recipients.Clin Transplant,2008,22(5):562-566.
[3]Clark NM.AST infectious diseases community of practice.Nocardia in solid organ transplant recipients.Am J Transplant,2009,9(Suppl 4):S70-S77.
[4]Blackmon KN,Ravenel JG,Gomez JM,et al.Pulmonary nocardiosis:Computed tomography features at diagnosis.J Thorac Imaging,2011,26(3):224-229.
[5]Tsujimoto N,Saraya T,Kikuchi K,et al.High-resolution CT findings of patients with pulmonary nocardiosis.J Thorac Dis,2012,4(6):577-582.
[6]徐凯,杜瑶,王沄,等.肺部诺卡菌感染的胸部CT特点.中华放射学杂志,2013,47(9):808-810.
[7]Buckley JA,Padhani AR,Kuhlman JE.CT features of pulmonary nocardiosis.J Comput Assist Tomogr,1995,19(5):726-732.
[8]Kanne JP,Yandow DR,Mohammed TL,et al.CT findings of pulmonary nocardiosis.AJR Am J Roentgenol,2011,197(2):W266-W272.
[9]Uttamchandani RB,Daikos GL,Reyes RR,et al.Nocardiosis in30patients with advanced human immunodeficiency virus infection:Clinical features and outcome.Clin Infect Dis,1994,18(3):348-353.
[10]Hui CH,Au VW,Rowland K,et al.Pulmonary nocardiosis revisited:Experience of 35 patients at diagnosis.Respir Med,2003,97(6):709-717.
[11]Wang HK,Sheng WH,Hung CC,et al.Clinical characteristics,microbiology,and outcomes for patients with lung and disseminated nocardiosis in a tertiary hospital.J Formos Med Assoc,2013Sep 2.[Epub ahead of print].
[12]Lerner PI.Nocardiosis.Clin Infect Dis,1996,22(6):891-903.
[13]郭川,林上奇,尤四峰,等.诺卡菌病的CT与MRI表现.中华放射学杂志,2014,48(1):58-60.
[14]张金娥,赵振军,何晖,等.胸部放线菌病的影像学特征.中国医学影像技术,2009,25(6):1015-1017.
[2]Khan BA,Duncan M,Reynolds J,et al.Nocardia infection in lung transplant recipients.Clin Transplant,2008,22(5):562-566.
[3]Clark NM.AST infectious diseases community of practice.Nocardia in solid organ transplant recipients.Am J Transplant,2009,9(Suppl 4):S70-S77.
[4]Blackmon KN,Ravenel JG,Gomez JM,et al.Pulmonary nocardiosis:Computed tomography features at diagnosis.J Thorac Imaging,2011,26(3):224-229.
[5]Tsujimoto N,Saraya T,Kikuchi K,et al.High-resolution CT findings of patients with pulmonary nocardiosis.J Thorac Dis,2012,4(6):577-582.
[6]徐凯,杜瑶,王沄,等.肺部诺卡菌感染的胸部CT特点.中华放射学杂志,2013,47(9):808-810.
[7]Buckley JA,Padhani AR,Kuhlman JE.CT features of pulmonary nocardiosis.J Comput Assist Tomogr,1995,19(5):726-732.
[8]Kanne JP,Yandow DR,Mohammed TL,et al.CT findings of pulmonary nocardiosis.AJR Am J Roentgenol,2011,197(2):W266-W272.
[9]Uttamchandani RB,Daikos GL,Reyes RR,et al.Nocardiosis in30patients with advanced human immunodeficiency virus infection:Clinical features and outcome.Clin Infect Dis,1994,18(3):348-353.
[10]Hui CH,Au VW,Rowland K,et al.Pulmonary nocardiosis revisited:Experience of 35 patients at diagnosis.Respir Med,2003,97(6):709-717.
[11]Wang HK,Sheng WH,Hung CC,et al.Clinical characteristics,microbiology,and outcomes for patients with lung and disseminated nocardiosis in a tertiary hospital.J Formos Med Assoc,2013Sep 2.[Epub ahead of print].
[12]Lerner PI.Nocardiosis.Clin Infect Dis,1996,22(6):891-903.
[13]郭川,林上奇,尤四峰,等.诺卡菌病的CT与MRI表现.中华放射学杂志,2014,48(1):58-60.
[14]张金娥,赵振军,何晖,等.胸部放线菌病的影像学特征.中国医学影像技术,2009,25(6):1015-1017.