Bankier A A, Stauffer F, Fleischmann D, Kreuzer S, Strasser G, Mossbacher U, Mallek R
Department of Radiology, University of Vienna, Austria.
J Thorac Imaging. 1998 Oct;13(4):282-8. doi: 10.1097/00005382-199810000-00008.
The authors studied radiographs and clinical histories of 29 patients with acquired immunodeficiency syndrome, symptoms of pulmonary infection, and simultaneous microbiologic evidence of Mycobacterium xenopi in the respiratory tract. The presence, nature, and distribution of radiographic abnormalities were determined and analyzed in accord with clinical information. In 26 (90%) patients, M. xenopi was the only microorganism that could be isolated. Chest radiographs were normal in 13 patients (45%) and abnormal in 16 patients (55%). Radiographic abnormalities were bilateral in 94% of cases and predominantly involved the lower lobes. Patchy peribronchial opacities (44%) and miliary nodules (24%) were the most common abnormalities. Reticular opacities and parenchymal consolidation were seen in 12% of patients. Pleural effusion was seen in 18% of patients. No patients had cavitations or adenopathy. There was no statistically significant difference regarding the mean age (38.7+/-7.3 years vs. 40.2+/-11.0 years), the duration of clinically evident human immunodeficiency virus infection (2.7+/-1.2 years vs. 2.8+/-1.4 years), and the mean of CD4 cell counts (50.6+/-15.3 cells/ml vs. 47.4+/-15.9 cells/ml) between the patients with and without abnormalities on chest radiographs. In patients with acquired immunodeficiency syndrome, pulmonary infection, and simultaneous microbiologic evidence of M. xenopi, chest radiographs can be normal in a substantial number of cases. When radiographic abnormalities are present, they differ from those seen in patient not infected with the human immunodeficiency virus who had pulmonary infection caused by M. xenopi and from patients with acquired immunodeficiency syndrome and pulmonary infection with nontuberculous mycobacteria other than M. xenopi. Although these findings are not specific, they may be of importance in the imaging of patients with acquired immunodeficiency syndrome, notably in areas where M. xenopi is endemic.
作者研究了29例获得性免疫缺陷综合征患者的X光片和临床病史，这些患者有肺部感染症状，且呼吸道同时有偶发分枝杆菌的微生物学证据。根据临床信息确定并分析了X光片异常的存在、性质和分布情况。26例（90%）患者中，偶发分枝杆菌是唯一可分离出的微生物。13例患者（45%）的胸部X光片正常，16例患者（55%）异常。94%的病例X光片异常为双侧性，主要累及下叶。斑片状支气管周围模糊影（44%）和粟粒状结节（24%）是最常见的异常表现。12%的患者可见网状模糊影和实质实变。18%的患者有胸腔积液。无患者出现空洞或淋巴结肿大。胸部X光片有异常和无异常的患者在平均年龄（38.7±7.3岁 vs. 40.2±11.0岁）、临床明显的人类免疫缺陷病毒感染持续时间（2.7±1.2年 vs. 2.8±1.4年）以及CD4细胞计数平均值（50.6±15.3个/毫升 vs. 47.4±15.9个/毫升）方面无统计学显著差异。在获得性免疫缺陷综合征、肺部感染且同时有偶发分枝杆菌微生物学证据的患者中，相当一部分病例的胸部X光片可正常。当存在X光片异常时，它们与未感染人类免疫缺陷病毒但由偶发分枝杆菌引起肺部感染的患者以及患有获得性免疫缺陷综合征且由非偶发分枝杆菌以外的非结核分枝杆菌引起肺部感染的患者所见的异常不同。尽管这些发现不具有特异性，但它们可能对获得性免疫缺陷综合征患者的影像学检查具有重要意义，尤其是在偶发分枝杆菌为地方病的地区。
