Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA.
Curr Opin Infect Dis. 2011 Aug;24(4):309-14. doi: 10.1097/QCO.0b013e328348b2e1.
The aim is to review imaging advances in invasive fungal pneumonia in cancer and transplant recipients and how their use can help guide treatment.
Early chest computed tomographic (CT) imaging of immunocompromised patients with neutropenic fever leads to improved survival. Some of the typical CT findings of invasive fungal pneumonia are transitory and are most common during the first week of symptoms. The reversed halo sign, an early sign of disease, is more common in mucormycosis. During the first 10 days of infection, invasive fungal pneumonia nodules may grow on follow-up CT scans, but this does not necessarily equate to worsening disease. Because of the excessive radiation of chest CT and because pulmonary nodule size typically expands during the first few weeks of treatment, follow-up CT scans should be ordered only when therapy changes are dependent on imaging findings.
Early chest CT imaging in immunocompromised patients suspected of having invasive fungal pneumonia can help identify disease early, leading to improved outcome.
本综述旨在探讨癌症和移植受者侵袭性真菌性肺炎的影像学进展，以及其应用如何有助于指导治疗。
中性粒细胞减少性发热的免疫功能低下患者的早期胸部计算机断层扫描（CT）成像可提高生存率。侵袭性真菌性肺炎的一些典型 CT 表现是短暂的，在症状出现的第一周最常见。反转晕征是疾病的早期征象，在毛霉菌病中更为常见。在感染的头 10 天内，侵袭性真菌性肺炎结节在后续 CT 扫描中可能会增大，但这并不一定意味着疾病恶化。由于胸部 CT 辐射过多，并且由于肺结节大小通常在治疗的最初几周内扩大，因此只有在影像学发现依赖于治疗改变时才应下发病灶的随访 CT 扫描。
对疑似侵袭性真菌性肺炎的免疫功能低下患者进行早期胸部 CT 成像有助于早期识别疾病，从而改善预后。
