文献类型：期刊文献

中文题名：在血液肿瘤患者肺部侵袭性真菌感染中CT影像学检查的诊断价值

英文题名：Diagnostic value of CT imaging in pulmonary invasive fungal infection in patients with hematological malignancies

作者：刘宇亭[1];段早晖[2];夏瑞明[1];姚克林[1];赵森[1]

机构：[1]绍兴文理学院附属医院放射科;[2]上饶市肿瘤医院放射科

年份：2017

卷号：27

期号：5

起止页码：1043

中文期刊名：中华医院感染学杂志

外文期刊名：Chinese Journal of Nosocomiology

收录：CSTPCD、、北大核心2014、CSCD_E2017_2018、北大核心、CSCD

基金：浙江省医药卫生科技基金资助项目(2011KYA135)

语种：中文

中文关键词：CT影像学检查;血液肿瘤;肺部侵袭性真菌感染;诊断价值

外文关键词：CT imaging examination; Hematological malignancies; Pulmonary invasive fungal infection; diagnostic value

中文摘要：目的研究CT影像学检查在血液肿瘤患者发生肺部侵袭性真菌感染的诊断价值。方法选取2012年1月-2016年5月选择医院接诊的68例血液肿瘤患者,所有患者采用CT影像学进行检查。分析X线胸片诊断与CT诊断发生肺部侵袭性真菌感染率比较、肺部真菌感染类型、病原菌分布构成比、患者的CT影像学特征表现。结果 35例患者发生肺部侵袭性真菌感染,感染率为51.47%;肺部真菌感染患者经CT影像学检测,肺部真菌感染的类型主要有弥漫型、曲菌球型、实变型和结节型,分别占37.14%、25.71%、22.86%和14.29%;35例患者按照《全国临床检查操作规程》进行病原学诊断,均呈现阳性,阳性率为100.00%;X线胸片诊断8例呈阳性,阳性率22.85%;CT影像诊断31例,阳性率88.57%,CT影像诊断阳性率明显高于X线胸片诊断,两组比较差异有统计学意义(P<0.05);病原菌分布主要是以曲霉菌属为主,其次为假丝酵母菌属、隐球酵母菌属;CT影像学特征包括结节或肿块影、晕征、空洞。结论 CT影像学检查在肺部侵袭性真菌感染的诊断具有非常重要的意义,能够提供有效的诊断依据,特别是在肺部真菌感染的早期治疗中,结合患者临床的基础疾病,可以初步的诊断肺部真菌感染,具有良好的临床参考价值,值得在临床上广泛推广。

外文摘要：OBJECTIVE To investigate the value of CT imaging in diagnosis of pulmonary invasive fungal infection in patients with hematological malignancies. METHODS A total of 68 cases of patients with hematological malig- nancies from Jan. 2012 to May 2016 in our hospital were selected. All patients were examined by CT imaging. The comparison of invasive pulmonary fungal infection rate between X-ray diagnosis and CT diagnosis, pulmonary fungal infection types, pathogenic bacteria distribution ratio, and the CT imaging features of patients were ana- lyzed. RESULTS There were 35 patients occurred pulmonary invasive fungal infection, with the infection rate of 51.47%. The types of pulmonary fungal infection included： diffuse type, aspergilloma type, consolidation type, and nodular type, accounting for 7.14%, 25.71%, 22.86%, and 14.29%, respectively. In accordance with the ＂ National Clinical Practice＂ for etiological diagnosis, 35 patients were all positive, with the positive rate of 100. 00%. Totally 8 cases were positive by X-ray diagnosis, with the positive rate of 22.85%, and 31 cases were posi- tive by CT imaging diagnosis, with the positive rate of 88.57%. The positive rate of X-ray diagnosis was significantly higher than that of X ray （P〈0.05）. The distribution of pathogenic bacteria was mainly composed of Aspergillus spp, and followed by Candida spp and Cryptococcus spp. CONCLUSION The CT imaging has a very important significance in the diagnosis of pulmonary invasive fungal infections in patients with hematologic malig- nancies. It can provide effective diagnostic basis, especially in the early treatment of pulmonary fungal infection. Combined with the patiengs clinical underlying disease, it can be a preliminary diagnosis of pulmonary fungal infection. It has a good clinical reference value, and is worth to be widely spread in clinical practice.