Blum U, Windfuhr M, Buitrago-Tellez C, Stöver B, Kreisel W, Lindemann A, Herbst E W, Langer M
Abteilung Röntgendiagnostik, Universitätsklinik Freiburg.
Rofo. 1994 Oct;161(4):292-9 E. doi: 10.1055/s-2008-1032535.
In a prospective study we examined the diagnostic ranking of CT and MR in 52 immunocompromised patients with nodular pulmonary lesions and clinical suspicion of invasive pulmonary aspergillosis (IPA). For early diagnosis of IPA (clinical symptoms having existed for less than 10 days) the CT halo sign proved highly sensitive and specific. MRT showed at this time a comparatively high sensitivity but only low specificity that could not be improved upon after Gd-DTPA. At a later stage of the aspergillosis infection (clinical symptoms manifested for more than 10 days) MR identified aspergillus-specific lesions with on-target characteristics (marked enhancement of margins after Gd-DTPA) or the so-called "reverse" target phenomenon (T2-weighted sequences). Such lesions were never seen in the early stage of the disease in patients with nodular pulmonary lesions of different aetiology (pseudomonal or staphylococcal pneumonia).
在一项前瞻性研究中，我们对52例有结节性肺部病变且临床怀疑为侵袭性肺曲霉病（IPA）的免疫功能低下患者进行了CT和MR的诊断排名评估。对于IPA的早期诊断（临床症状出现少于10天），CT晕征显示出高度的敏感性和特异性。此时MRT显示出相对较高的敏感性，但特异性仅较低，注射钆喷酸葡胺（Gd-DTPA）后也无法改善。在曲霉病感染的后期（临床症状出现超过10天），MR识别出具有靶征特征（注射Gd-DTPA后边缘明显强化）或所谓“反”靶征现象（T2加权序列）的曲霉特异性病变。在不同病因（假单胞菌或葡萄球菌肺炎）的结节性肺部病变患者的疾病早期从未见过此类病变。
