Đặc điểm hình ảnh bệnh nấm phổi trên X quang trường quy và chụp cắt lớp vi tính

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DAC DIEM HINH ANH BENH NAM PHOI

TREN XQUANG THI/&NG QUY VA CHUP CAT LOfP VI TINH

TOM TAT

Vi chin doin hinh anh, Chyp Xquang thuong quy

(XQ) va chyp cat l&p vi tinh(CLVT) li ky thupt dwgc chgn

de chin doan nim phoi. Myc tieu: Md ti dpe diim hinh

anh eiia nim phoi tren XQ thtr&ng quy va CLVT. Doi

twgng vi phwong phip nghien ciru: hdi cuv 34 bpnh

nhan nim phoi cd chin doin giii phau bpnh vi/hope

nudi ciy dtrang tinh, diiu tri phau thupt, hope ngi khoa,

dtrgc chyp XQ vi CLVT. Ket qua: Ton thuong chu yiu

eua nim phoi & thiiy tren hai phoi (67,6 73,5%) v&i

hinh anh "lyc Ipc" tir 50- 70,6%>. Mgt so diu hipu hinh

anh khic khd chin doin phan bipt v&i cae bpnh ly viem

do nguyen nhan khae hay do u. XQ thtr&ng quy chin

doan nim phoi so v&i chyp CLVT cd dg nhay 70,8%, dg

dae hipu la 100%, v&l p<0,001. Ket lupn: Hinh anh nim

phoi tren Xquang vi CLVT da dpng, khd chin doin trir

the u nim. Cic hinh inh khdng dpc hipu tirong ty eie

bpnh ly phoi do nguyen nhin khic.

Tir khda: Nim phoi, XQ, CLVT.

SUMMARY

Chest Standard Xray and computed tomography are

radiologically tow techniques for diagnosing the

Aspergillosis. Objective: Describe the characteristic

imaging of the Aspergillosis with the Chest Standard

Xray as well as the pulmonary computed tomography.

Object and methodology: Pmspeetively, on 34 patients

who were been diagnosed by pathology examination

and/or positive sample culture and/or the result of

pulmonary resection surgery or the good response to

medical treatment Result: The lesions of the

Aspergillosis were located on the both upper lobes of

lung (ranging from 67.3 to 73.5%,) and wem

predominantly showed by "bell" sign of 50 to 70.6%).

There were also some others signs that wem

not specific for the Aspergillosis as well as the

alternative causes. On diagnosing the Aspergillosis, the

Chest Standard Xray compamd to pulmonary computed

tomography had the sensitivity of 70.8% and the

specificity of 100% , p<0.001. Conclusion: Aspergillosis

characteristics on the Chest Standard Xray and the

BIJI VAN LENH

Benh vien Dai hgc Y Ha Ngi

pulmonary computed tomography were multiform and

difficult to make diagnosis, except the Aspergilloma

form. Those were as non-specific as the findings of

altemative pulmonary diseases.

Keywords: Aspergillus, Aspergilloma,Candida, Xray,

computed tomography.

OAT VA N D E

Nam phdi la bpnh co hpi, it ggp. Chung Aspergillus

fumigatus va Candida hay gay nam phdi nhat la d co dja

suy giam miln djch, lao hang... Dau hipu Idm sang

thudng khdng dgc hipu; ho, ho ed ddm dgc, ho ra mau

[1]...Chyp XQuang thudng quy (XQ) va chyp cat Idp vi

tinh (CLVT) gdp phan khdng nhd trong chan dodn nam

phdi. Chung tdi tiln hanh nghien eiru d l tdi ndy vdi myc

tieu: Mo ti dpc diem hinh anh cua nam phoi tren XQ

thw&ng quy vi CLVT.

D 6 | TU'Q'NG VA PHU-QNG PHAP

Nghien cu'u md ta elt ngang, hdi cu'u 34 trudng hpp

nim phdi dupe dilu trj tgi bpnh Vipn Phdi Trung Lfong,

bpnh vipn Vipt Oirc tu' 2005 - 2010. Cd kit qud giai phdu

bpnh hope soi tuoi, nudi cay la nim. Cd phim XQ phoi

chuan vd phim CLVT.

K £T QUA NGHIEN CU'U

1. Ode dilm vl lo-p tuoi, giai, nghi nghipp

Trung binh 47,9±15,0 tudi (tre nhat 6 tuoi, cao nhat

77 tudi). Tudi dudi 20 la 2,9%, 20 - 40 tudi Id 26,5%,

nhdm cao nhat 41- 60 tudi (53,0%). Tren 60 tudi 17,6%.

Ty lp nam/nu' 2,4/1. Ndng dan va cong nhan ed ty lp mde

cao (52,9% va 14,7%).

2. Cac ylu t6 nguy ca cua bpnh nhan ndm phli

2.1. Cic yeu to nguy cv chung

Cdc trudng hpp cd bpnh phdi mgn tinh chilm 52,9%,

bpnh khop, ty miln 11,8%, eae bpnh mgn tinh khdc (dai

thdo dudng, tim mgch...) 14,7%.

2.2. Tien si> cac bpnh ve phoi

Lao eu chilm 41,2%, viem, gian phi quan mgn 5,8%,

ung thu phoi 2,9%.

3. Lam sang

Gay silt edn ehilm 94,1%, ho ra mau 76,5%, sot

41,2%, ho khan 38,2%, ho cd ddm 52,9%, khd thd 50%,

dau ngye 64,7%.

54 Y HOC THUC HANH (755) - S6 3/2011