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目的探讨变应性支气管肺曲霉病(ABPA)的胸部X线及CT表现。方法回顾性分析2005年12月-2013年12月收治的20例ABPA的胸部X线、CT表现。结果胸部X线检查结果显示4例为阴性,14例可见实变影,10例可见肺纹理增粗、紊乱,5例可见支气管扩张。胸部CT结果显示1例为阴性,18例可见支气管扩张,17例可见中心性支气管扩张,其中6例为中心及外周支气管均受累,仅1例表现为单纯外周支气管扩张,11例可见树芽征,6例可见黏液栓,8例可见实变影,5例可见磨玻璃影,4例可见胸膜增厚,3例可见胸腔积液,2例可见肺不张。结论对于过敏性哮喘及肺囊性纤维化患者,出现中心性支气管扩张可以提示ABPA,但不能作为特异性表现。支气管扩张伴高密度黏液栓,虽然少见,却可能是该病的特异性表现。
Objective To investigate the chest X-ray and CT findings of allergic bronchopulmonary aspergillosis (ABPA). Methods The chest X-ray and CT findings of 20 cases of ABPA from December 2005 to December 2013 were retrospectively analyzed. Results Chest X-ray examination showed that 4 cases were negative, 14 cases can be seen real change shadow, 10 cases can be seen thickening of the lungs, disorders, 5 cases of bronchiectasis. Chest CT results showed that 1 case was negative, 18 cases of bronchiectasis, 17 cases of central bronchiectasis, including 6 cases of central and peripheral bronchial involvement, only 1 case showed simple peripheral bronchiectasis, 11 cases visible sprout sign , Mucus suppository was seen in 6 cases, real consolidation was observed in 8 cases, ground glass was observed in 5 cases, pleural thickening was seen in 4 cases, pleural effusion was seen in 3 cases, and atelectasis was seen in 2 cases. Conclusion In patients with allergic asthma and cystic fibrosis, central bronchiectasis may suggest ABPA, but not as a specific manifestation. Bronchiectasis with high density mucus plug, although rare, may be the specific manifestation of the disease.