螺旋CT在老年真菌性肺部感染早期筛查中的影像学特征及诊断优势分析OA
Analysis of the imaging features and diagnostic advantages of spiral CT in the early screening of fungal pulmonary infection in the elderly
目的 分析多层螺旋 CT(multi-slice spiral CT,MSCT)检查应用于老年真菌性肺部感染早期筛查中的影像学特征,并探讨该诊断方案的具体优势.方法 选取安徽省天长市人民医院2023 年 1 月—2024 年 12 月收治的 58例疑似真菌性肺部感染老年患者为研究对象,所有患者均接受胸部 X 线检查和 MSCT 检查,以病原培养结果为金标准,比较两种方法的诊断效能,并分析 MSCT 影像特征.结果 该研究共有 50 例患者确诊;X 线检出 35 例,MSCT 检出49 例,MSCT 的灵敏度、特异度、诊断准确度、阳性预测值、阴性预测值均高于 X 线(P<0.05);致病菌以曲霉占比最高(42.00％,21/50);病灶多见于左肺下叶(44.00％,22/50)和右肺上叶(42.00％,21/50).MSCT 征象中,实变影发生率最高(58.00％,29/50).不同致病菌存在优势征象:晕征、空气新月征最多见于曲霉感染;念珠菌感染以实变影与磨玻璃影为主;隐球菌感染则主要表现为结节影.结论 MSCT 对老年真菌性肺部感染的早期筛查效能显著优于 X 线.不同致病菌的 MSCT 征象存在一定特征性差异,能为病原学早期辅助鉴别诊断提供重要线索,但其表现复杂且存在重叠,临床诊断仍需结合宿主因素与实验室检查进行综合判断.
Objective To analyze the imaging features of multi-slice spiral CT(MSCT)examination in the early screening of fungal pulmonary infection in the elderly,and to explore the specific advantages of this diagnostic scheme.Methods Fifty-eight elderly patients with suspected fungal pulmonary infection admitted to Tianchang People's Hospital from January 2023 to December 2024 were selected as the research subjects.All patients underwent chest X-ray examination and MSCT examination.Taking the pathogen culture results as the gold standard,the diagnostic efficacy of the two methods was compared,and the MSCT imaging features were analyzed.Result A total of 50 patients were diagnosed with fungal pulmonary infection in this study.Thirty-five cases were detected by X-ray and 49 cases were detected by MSCT.The sensitivity,specificity,diagnostic accuracy,positive predictive value and negative predictive value of MSCT were all higher than those of X-ray(P<0.05).The pathogen accounted for the highest proportion of Aspergillus(42.00％,21/50).The lesions were mostly found in the lower lobe of the left lung(44.00％,22/50)and the upper lobe of the right lung(42.00％,21/50).Among the MSCT signs,the incidence of consolidation shadow was the highest(58.00％,29/50).Different pathogenic fungus had dominant signs:Aspergillus infection was more likely to present halo signs,cavities with crescent signs.Candida infection was mainly characterized by consolidation shadows and ground-glass shadows.Cryptococcal infection was mainly manifested as nodular shadows.Conclusion The early screening efficacy of MSCT for fungal pulmonary infections in the elderly is significantly better than that of X-ray.The MSCT signs of different pathogen have certain characteristic differences,which can provide important clues for the early auxiliary differential diagnosis of etiology.However,their manifestations are complex and overlap,and clinical diagnosis still needs to be comprehensively determined by combining host factors and laboratory tests.
韩玉龙;沈小东
天长市人民医院影像科,安徽天长 239300浙江省舟山医院核医学科,浙江 舟山 316000
螺旋CT检查老年真菌性肺部感染早期筛查影像学特征
spiral CT examinationfungal pulmonary infections in the elderlyearly screeningimaging features
《中国真菌学杂志》 2026 (2)
134-140,7
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