张金娥,赵振军,何晖,刘春玲,梁长虹.胸部放线菌病的影像学特征[J].中国医学影像技术,2009,25(6):1015~1017
胸部放线菌病的影像学特征
Imaging features of thoracic actinomycosis
投稿时间:2008-10-09  修订日期:2009-03-26
DOI:
中文关键词:  放线菌病  胸部    X线  体层摄影术  X线计算机
英文关键词:Actinomycosis  Thorax  Lung  X-ray  Tomography, X-ray computed
基金项目:
作者单位E-mail
张金娥 广东省人民医院放射科 广东省医学科学院,广东 广州 510080  
赵振军 广东省人民医院放射科 广东省医学科学院,广东 广州 510080  
何晖 广东省人民医院放射科 广东省医学科学院,广东 广州 510080  
刘春玲 广东省人民医院放射科 广东省医学科学院,广东 广州 510080  
梁长虹 广东省人民医院放射科 广东省医学科学院,广东 广州 510080 dr_liang62@hotmail.com 
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中文摘要:
       目的 观察胸部放线菌的X线平片及CT特征。方法 回顾性分析5例胸部放线菌病患者的影像学资料。结果 5例患者中,3例经支气管纤维镜活检、1例经CT穿刺、1例经手术病理确诊。5例X线正、侧位胸片显示团块和大片密实影,未见空洞、气体和液化灶;CT示病变共累及9个肺叶,26个肺段。4例以团块为主要病灶(其中2例见2个肿块),周围肺见多发斑点、斑片及条索状模糊影;5个团块内均见空洞,薄壁,内壁光滑;空洞内充满低密度液化灶和散在悬浮的气体影,但未见气-液平面,是本组病例较典型的CT表现。5例均见邻近胸膜增厚,4例肺门和(或)纵隔淋巴结增大;1例右肺斑片状影合并纵隔脓肿。结论 以团块内出现空洞为主要表现的胸部放线菌CT表现具有特征性:空洞壁薄、内壁光滑、空洞内充满液化灶和散在悬浮的气体影且不形成气-液平面,可显示病灶的细节征象。X线平片诊断此病价值有限。
英文摘要:
      Objective To observe X-ray and CT features of thoracic actinomycosis. Methods Image data of 5 cases with thoracic actinomycosis were retrospectively analyzed. Results Three cases were diagnosed with bronchoscopy, 1 case with CT-guided biopsy and the other with operation. All the cases showed clump and plaque density, but no cavity, air or liquation was found on chest X-ray film. CT showed foci distributed in 9 lobes and 26 segments. Lump was the main abnormality in 4 cases (2 cases with 2 lumps respectively). Multiple blurred spots, patchies and stripes were found around the lumps. Cavity was found inside 6 lumps, and thin wall, smooth inner, low density liquation and suspended air bubbles, but no air-fluid levels in the cavity were characteristic signs. Vicinity pleural thickening was found in 5 cases, lymphadenovarix in hilar and/or mediastinum in 4 cases and blurred patches in right lung incorporated mediastinal abscess in 1 case. Conclusion CT characteristics of thoracic actinomycosis contributes to display the details of thoracic actinomycosis, including cavity in the lump with thick wall, smooth inner, low density liquation and suspended air bubbles, but no air-fluid level, whereas chest X-ray film has limited diagnostic value for thoracic actinomycosis.
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