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肺部隐球菌病的临床和影像学特征:中国 118 例非艾滋病患者的对比分析。

Clinical and imaging characteristics of pulmonary cryptococcosis: a comparative analysis of 118 non-AIDS patients in China.

机构信息

Department of Science and Education, Jiangmen Central Hospital, Jiangmen 529000, China.

Department of Respiratory and Critical Care Medicine, Jiangmen Central Hospital, Jiangmen 529000, China.

出版信息

Med Mycol. 2023 Mar 2;61(3). doi: 10.1093/mmy/myad019.

Abstract

The accurate diagnosis of pulmonary cryptococcosis (PC) is an important guarantee for the selection of reasonable treatment methods. In this paper, the clinical and imaging manifestations of PC in non-AIDS patients were retrospectively analyzed, and according to whether there was an underlying disease, a comparative analysis was carried out to deepen the understanding of PC, and improve the accuracy of its diagnosis. Both clinical and CT imaging data of 118 PC patients were analyzed retrospectively. The clinical manifestations of PC patients were not specific, and 61 patients had no apparent symptoms. A total of 49 patients (49/118) were treated with antifungal agents alone, 46 of them had follow-up records after treatment, and 91.3% (42/46) of them achieved a good outcome. The most common imaging sign was the subpleural nodule or mass. Other main imaging signs include bronchial air sign (50/118), halo sign (32/118), ring target sign (65/118), lobulation sign (72/118), and necrosis (76/118). In terms of age, halo sign, and ring target sign, there were significant differences between the group with underlying disease and the group without underlying disease (P < .05). The CT manifestations of PC have some characteristics, and using antifungal agents can achieve good outcomes.

摘要

肺隐球菌病(PC)的准确诊断是选择合理治疗方法的重要保证。本文回顾性分析了非 AIDS 患者 PC 的临床和影像学表现,并根据是否存在基础疾病进行了对比分析,以加深对 PC 的认识,提高其诊断准确性。回顾性分析了 118 例 PC 患者的临床和 CT 影像学资料。PC 患者的临床表现不具特异性,61 例患者无明显症状。共有 49 例(49/118)患者单独接受了抗真菌治疗,其中 46 例有治疗后随访记录,91.3%(42/46)患者获得了良好的结果。最常见的影像学征象是胸膜下结节或肿块。其他主要的影像学征象包括支气管充气征(50/118)、晕征(32/118)、环靶征(65/118)、分叶征(72/118)和坏死(76/118)。在年龄、晕征和环靶征方面,有基础疾病组与无基础疾病组之间存在显著差异(P<.05)。PC 的 CT 表现具有一定特征,使用抗真菌药物可取得良好的效果。

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