Radiographic Manifestation of Pneumocystis carinii Pneumonia (PCP): A 5-Year Experience at Veterans General Hospital-Taipei (VGHTPE) (1996-2001)

卡氏肺囊蟲肺炎的胸部放射學表現：台北榮總5年（1996～2001）經驗

蔡清和(Ching-Ho Tsai) ； 賴信良(Shinn-Liang Lai)

《胸腔醫學》 17卷4期 (2002/12) Pp. 317-323

摘要

卡氏肺囊蟲肺炎是免疫不全的人最常見且嚴重的伺機性感染，我們回顧台北榮總最近5年（1996～2001）36位卡氏肺囊蟲肺炎病人患病早期的胸部X光片，來分析各種胸部放射學類型出現的相對機率，這些病人是經由病因診斷或對bactrium治療有進步。成人免疫不全症候群大約有百分之陸拾的機率會發生卡氏肺囊蟲肺炎。36位病人中有26位是成人免疫不全症候群病人，4位是腎臟移植病人；其中有32位是男性，4位是女性。
最常見的胸部放射學表現為兩側肺門旁瀰漫性間質型浸潤，佔百分之六十一點一。 其他不同的表現有肺泡型、毛玻璃狀型，且亦可能以囊狀病灶及肋膜積水表現。在36位病人中有18位接受電腦斷層掃描，我們亦回顧其片子，找出最常見的類型為毛玻璃狀型(佔百分之九十四點四)。
在這疾病早期診斷、快速治療，是相對的重要。雖然沒有一種胸部放射學的表現能像病理提供那麼確定的診斷，但其可給于最早的警訊。

關鍵字

卡氏肺囊蟲肺炎 ； 肺門旁瀰漫性間質型浸潤 ； 放射學表現

並列摘要

Pneumocystis carinii pneumonia (PCP) is a central and serious opportunistic infection in the immunocompromised host. We reviewed the initial chest roentgenograms of 36 patients whose PCP was diagnosed by etiology or by treatment response to Bactrim between 1986 and 2001, at Veterans General Hospital-Taipei, to detect the relative frequencies of its various roentgenographic patterns. PCP is estimated to occur in approximately 60 percent of patients with AIDS. Among the 36 patients reviewed, 26 had AIDS, and 4 had undergone a renal transplantation. The sex distribution was 32 males and 4 females. The most common radiographic pattern was a diffuse perihilar interstitial infiltration in twenty-two of the 36 patients (61.1 percent). Other radiographic manifestations consisted of alveolar patterns, ground glass patterns, cystic lesions, and pleural effusion. Eighteen of the 36 patients had accepted a chest CT examination, and we also reviewed the most frequent patterns. Early diagnosis and rapid treatment are relatively important with this disease. The radiographic manifestations may aid in the diagnosis of this disease, though there is no pathognomonic radiographic pattern for PCP.

並列關鍵字

pneumocystis carinii pneumonia ； diffuse perihilar interstitial infiltration ； radiographic manifestation