Objective To determine the CT features of invasive pulmonary fungal infection (IPFI) in 76 patients with chronic severe hepatitis through analysis of the clinical manifestation and CT. Methods The CT manifestation of 76 chronic severe hepatitis patients with IPFI who underwent complete pulmonary thin-section CT examination were analyzed retrospectively . The distribution,extent, boundary, density and size of IPFI were observed and the correlation between these features and pathogenic bacteria was analyzed. Results (1) Pathogens: Candida albicans (n=35) was the most common fungus among 76 chronic severe hepatitis patients with IPFI, followed by aspergillus (n = 26) , cryptococcus neoformans (n = 10)and histoplasmosis (n = 3) , pneumocystis (n = 2). (2) CT findings: nodules (30 , 39. 1 %) was the most common imaging finding of 76 chronic severe hepatitis patients with IPFI, followed by consolidations(25 ,32. 9%), reticular or linear opacities(10,13. 2%) , ground-glass attenuations (6,7. 9%) ,pleural effusion (5,6. 6%). Consolidation is the most common imaging finding in Candida albicans infection (18, 51. 4%) , nodules is the most common imaging finding in aspergillus infection(15 , 57. 7%). There were no statistically significant differences in the prevalence of CT patterns among different fungal infection (P>0. 05). Conclusion The CT findings are not specific in chronic severe hepatitis patients with IPFI. Exact diagnosis should be combined with clinical laboratory data, lesion distribution and disease development.%目的 了解慢性重型肝炎并发侵袭性肺真菌感染者的特征性CT表现.方法 回顾性分析76例经临床证实的慢性重型肝炎并发侵袭性肺真菌感染的CT表现,观察病变的形态、范围、边界、密度和病灶大小特点,并分析不同病原菌的CT特点.结果 76例慢性重型肝炎并发侵袭性肺真菌感染者中分离到念珠菌35株、曲霉菌26株、新型隐球菌10株、组织胞浆菌3株、肺孢子菌2株.CT征象表现为结节30例(39.1%)、实变25例(32.9%)、网格或线样影10例(13.2%)、磨玻璃影6例(7.9%)及胸腔积液5例(6.6%).其中念珠菌感染以斑片实变影最常见(18例,51.4%),曲霉菌感染以结节最常见(15例,57.7%),CT征象在各病原体感染中出现频率差异无统计学意义(均P>0.05).结论 慢性重型肝炎并发侵袭性肺真菌感染者CT表现缺乏特异性,应结合临床资料和病变分布及演变作出明确诊断.
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