摘要
目的:评估X光片及CT对HIV患者合并肺孢子菌肺炎的诊断价值。方法:回顾性分析经证实的42例HIV感染者合并肺孢子菌肺炎(PCP)临床及影像学资料,全部病例均经X线胸片(普通X光片及数字化X光片)检查,分别摄治疗前、治疗中、及治疗后胸片,其中24例经CT检查。结果:26例(61.9%)具有典型的双肺弥漫性、以肺门为中心、双肺对称性网结节状及斑片状高密度影,X线诊断为PCP,正确率为100%。不典型表现的16例全部进行了CT检查,其中9例(21.4%)表现肺多发性、囊性及实质性改变并经CT诊断;另外7例发病部位及影像学表现不典型,4例(9.5%)为多小叶渗出性病变,3例(7.1%)为大叶及局灶性实变,7例病人中仅有1例CT检查后确诊,其余6例均不能肯定诊断。X光片结合CT检查,对PCP诊断总符合率为85.7%。结论:对具有典型X线表现的病例,X光胸片符合率为100%;对不典型表现的病例,需行CT检查。X光片结合CT检查对确定HIV患者是否感染PCP较大帮助,其诊断符合率为85.7%。
Objective： To assess the diagnostic value of X ray and CT in HIV-positive patients with Pneumocystis carinii pneumonia （PCP）. Methods： The clinical and radiologic data of 42 HIV- positive patients with PCP were analyzed retrospectively. All patients had X ray （normal X ray and digital X ray） examination and 24 patients of them had CT examination. Results： Twenty-six patients （61.9%） diagnosed as PCP had typical diffuse reticular and nodular form of two lung lobes＇ symmetry and patching form of high density image in X-ray photos, and was the accuracy rate of diagnosis was 100 %. Sixteen cases of non-typical X-ray evidents took CT scan. By CT di- agnosis, the appearances of 9 cases （21. 4 %） had multifocal, multicystic, and parenchymatous changes. Another seven cases＇ lesion locations and imaging performances were not typical. Four among the seven cases （9.5%） were lobular leachability affection and three cases （7.1%） were grandifoliate and focal consolidation. Only one of the seven cases made a final diagnosis after CT scans. The other six cases could not diagnosed definitely. X ray and CT examination of diagnosis of PCP in HIV infected patients was 85.7%. Conclusion： For the diagnosis of typical PCP in X-ray, the accuracy rate is 100%. But for those without typical performances in X-ray, the patients should take CT examination. The diagnostic rate of X ray combined with CT is 85.7 % in diagnosing HIV infected patients with PCP.
出处
《武汉大学学报（医学版）》
CAS
2008年第5期680-682,686,共4页
Medical Journal of Wuhan University
基金
湖北省艾滋病全球基金资助项目(编号:GF06024)
关键词
艾滋病
X线
CT
肺孢子菌肺炎
AIDS
X-Ray
CT
PneurnocystisCarinii Pneumonia
