HIV阴性卡氏肺囊虫肺炎的影像学表现

Imaging manifestations of pneumocystis carinii pneumonia with HIV (-)

关键词:  肺炎  卡氏肺囊虫  影像学表现

Key words:  pneumocystis  carinii pneumonia  imaging manifestations

摘要:

［目的］ 探讨HIV阴性卡氏肺囊虫肺炎的影学像表现，提高鉴别诊断水平。［方法］收集经病理证实的HIV 阴性卡氏肺囊虫肺炎7例，其中肾移植术后患者5例，白血病化疗患者2例，均摄胸部X线片，3例行胸部CT扫描。［结果］7例均表现为双侧对称或不对称病变，1例为两肺均匀性、完全性实变，其内见支气管气像，3例呈网状结节影及斑片状影，部分融合成片状模糊阴影；3例表现为遍布全肺的浓密的云团状阴影，CT示肺内毛玻璃样、片状影以及和正常肺与病变组织交织嵌合构成马赛克图形。［结论］卡氏肺囊虫肺炎的影像表现呈多样性，X线胸片对本病的诊断有重要价值，最终确诊有赖于病理检查。

Abstract:

［Objective］To investigate the imaging manifestations of pneumocystis carinii pneumonia (PCP) with negative HIV.［Methods］Seven cases with pathologically proved PCP were collected. 5 cases of patients after renal transplantation, 2 cases of leukemia after chemotherapy, chest radiography was performed in all 7 cases, while additional chest CT scanning was done in 3 ones. ［Results］On plain chest radiograph, total 7 cases appeared symmetrical or asymmetrical lesions in both lungs. There was complete consolidation with air bronchogram in one case; netlike and nodule shadows with part of them confused as scattered opacity in 3 cases; and dense cluster shadows distributed all fields of both lungs in 3 cases. On CT scans, the lesinos showed signs of multiple ground glass opacification, patchy shadows, or mosaic pattern when the lesion was interwoven with normal lung parenchyma. ［Conclusion］PCP may exhibit a variety of imaging manifestation. Plain chest film is of value for the diagnosis of the disease although a definitive diagnosis depend on pathological evidence.