肺真菌病的影像诊断-2

肺真菌病的影像诊断

ImagingDiagnosisofPulmonaryMycoses彭文鸿解放军第306医院呼吸内科小叶中心性结节

Centrilobularnodule小叶中心性结节分布广泛，酷似随机分布的表现，但不累及胸膜面和小叶间隔。Centrilobularnodulesareusuallyofsimilarsizeandspacedatregulardistancesfromeachother.Ifthenodulesareeachatthecenterofalobule,theinternodulardistancewillbeapproximately1-2.5cm.Attheperipherytheyoccur5-10mmfromthepleuralsurface(1/2thediameterofalobule).Theyusuallyrepresentlinearperibronchiolarorbronchiolardensitiescutincross-section.淋巴管周围性结节

（Perilymphaticnodules）淋巴管周围结节主要在肺门旁的支气管血管周围区、小叶中心区和与小叶间隔和胸膜面有关。Groundglass,consolidation磨玻璃影Groundglassopacity肺密度模糊增加，但不掩盖其内部的肺血管。提示为活动性或急性病变。PCP马赛克衰减（Mosaicattenuation）Theterm‘mosaicattenuation’isusedtodescribedensitydifferencesbetweenaffectedandnon-affectedlungareas.

Therearepatchyareasofblackandwhitelung.

马赛克灌注，肺灌注的区域性差异，导致吸气时HRCT上可见肺衰减的差异。反映了血管阻塞或通气异常，多见于气道疾病透亮区的血管特征性地表现为较致密肺内的血管细小。呼气HRCT在由气道疾病中导致的马赛克灌注诊断上的价值。马赛克衰减（Mosaicattenuation）AirwayinvasiveaspergillosisMosaicattenuationPCPinAIDS实变影Consolidation肺衰减增加并掩盖了该区域内的肺血管，可见支气管空气征。completeopacificationofthisarea.Whenthebronchiremainaerated,theyareseenasbranchinglucenciescalledair-bronchograms,whicharepresentinthisimage.Thisimagerepresentsinfectiouspneumonia,whichislimitedbythemajorfissure,resultinginasharpborder.Theadvancinganteromedialmarginshowsground-glassopacity(seelater).实变影Consolidation支气管肺活检证实为曲霉性支气管炎和肺炎树芽征（TreeinBud）树芽征（TreeinBud）扩大的小叶中心细支气管，管腔内为黏液、液体或脓液所嵌塞，常伴细支气管炎症。Hypodensesign

(在实变及结节出现中心性低