Kawashima A, Kuhlman J E, Fishman E K, Tempany C M, Magid D, Lederman H M, Winkelstein J A, Zerhouni E A
Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, Maryland.
Skeletal Radiol. 1991;20(7):487-93. doi: 10.1007/BF00194242.
Pulmonary Aspergillus infection in patients with chronic granulomatous disease tends to involve the chest wall and consequently carries a high mortality rate. We report the findings of computed tomography (CT) and magnetic resonance imaging (MRI) in three such cases. One patient underwent both CT and MRI, one, CT only, and one, MRI only. In all three, both CT and MRI demonstrated pulmonary consolidations with direct extension to the adjacent chest wall. In both patients who were examined by CT, scans revealed permeative osteolytic changes of adjacent rib or spine compatible with osteomyelitis. In both patients who were examined by MRI, adjacent chest wall involvement was depicted on T1-weighted images and showed increased signal intensity on T2-weighted images. In one of these patients, the chest wall lesion was well defined on T2-weighted images, an appearance compatible with abscess. Epidural extension was demonstrated on MRI in the other patient, who later developed paraparesis. We suggest that CT and MRI have a complementary role in evaluating chest wall invasion by pulmonary Aspergillus infection in chronic granulomatous disease.
慢性肉芽肿病患者的肺部曲霉菌感染往往累及胸壁，因此死亡率很高。我们报告了3例此类病例的计算机断层扫描（CT）和磁共振成像（MRI）结果。1例患者同时接受了CT和MRI检查，1例仅接受了CT检查，1例仅接受了MRI检查。在所有3例中，CT和MRI均显示肺部实变并直接蔓延至相邻胸壁。在接受CT检查的2例患者中，扫描显示相邻肋骨或脊柱有弥漫性溶骨性改变，符合骨髓炎表现。在接受MRI检查的2例患者中，T1加权图像显示相邻胸壁受累，T2加权图像显示信号强度增加。在其中1例患者中，T2加权图像上胸壁病变边界清晰，表现符合脓肿。另一例患者MRI显示硬膜外蔓延，该患者后来出现了轻瘫。我们认为，CT和MRI在评估慢性肉芽肿病患者肺部曲霉菌感染对胸壁的侵犯方面具有互补作用。
