变应性支气管肺曲霉菌病的影像诊断

Radiological diagnosis of allergic bronchopulmonary aspergillosis

  • 摘要: 目的 探讨变应性支气管肺曲霉菌病的X线胸片及CT影像学特点。方法 回顾性分析9例变应性支气管肺曲霉菌病的CT及X线胸片表现。结果 9例患者X线胸片见"游走性"浸润影。CT显示9例均有中央性囊柱状支气管扩张,累及13个上叶,2个中叶,7个下叶。7例合并支气管黏液栓形成,其中高密度5例。7例伴远端小叶中心结节,3例见"树芽"征。2例合并远端阻塞性炎症。结论 游走性渗出影、中央性支气管扩张伴管腔内高密度黏液嵌塞为较特征X线胸片及CT表现,结合临床及血清免疫学检查可明确诊断。

     

    Abstract: Objective To study the characteristics of allergic bronchopulmonary aspergillosis(ABPA) on X-ray and CT films. Methods Findings in 9 ABPA patients on X-ray and CT films were retrospectively analyzed. Results " Migratory" exudative shadows were observed in 9 patients on X-ray and CT films.CT showed central sacculocylindrical brochiectasis in 9 patients involving 13 upper,2 middle and 7 lower lobes,respectively.Formation of bronchial mucus plugs was found in 7 patients with a high density in 5 of them.Central lobular nodules were demonstrated in the distal lobe of 7 patients with" tree-in-bud" signs in 3 of them.Distal obstructive inflammation was observed in 2 patients. Conclusion Migratory exudative shadows and central sacculocylindrical bronchiectasis with a higher density of mucoid impaction are the characteristic manifestations of allergic bronchopulmonary aspergillosis on X-ray and CT films.The diagnosis of allergic bronchopulmonary aspergillosis can be established according to its manifestations on X-ray and CT films in combination with clinical and serological examinations.

     

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