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The CT Imaging Analysis of Pneumocystis Carinii Pneumonia in AIDS

Author: GuoYan
Tutor: LiuAiShi
School: Inner Mongolia Medical University
Course: Medical Imaging and Nuclear Medicine
Keywords: AIDS Pneumocystis carinii Pneumonia Spiral CT Medical image
CLC: R512.91
Type: Master's thesis
Year: 2013
Downloads: 21
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Abstract


Objective To study CT findings of pneumocystis carinii pneumonia in AIDS and thecorrelation of CD4~+T lymphocytes and PCP image. To increase imaging awareness of AIDScomplicated with PCP and reduce the rate of misdiagnosis. Methods The CT imaging andCD4~+T lymphocytes assay of31patients with PCP in AIDS were retrospectively analyzed. Itcontained the correlation of CD4~+T lymphocytes assay and PCP image performance, the proneposition and image feature of PCP. A lung lobe acted a unit of analysis. The left lung wasanalyzed according to upper lobe, lower lobe and the whole lung. The right lung was analyzedaccording to upper lobe, lower lobe, middle, upper and middle lobes, middle and lower lobes,the whole lung; Image features was analyzed according to common image, rare image andcoexisting image. The America BD FAXS Calibur flow cytometry for detection and theActivion16TSX-031A spiral CT which were produced by Japanese Toshiba Co were theequipments. To scan from apex of lung to costophrenic angle at the end of a deep inspiration.Parameter settings: thickness of10mm,120kV,200mA, interval10mm, reconstructioninterval5mm. The image academic language followed Fleischner Society Committee onnomenclature named in2008. Results The imaging findings: diffuse bilateral pulmonarylesions(96.8%), focal (3.2%); symmetrical lesions (93.5%), asymmetrical lesions (6.5%). Forpatients whose CD4~+T cell <50/ul,50-100/ul and>100/ul, ground-glass opacities all were100%;nodular was54.5%,50%and33.3%(P>0.05);pneumatocele was36.3%,50%and66.7%(P>0.05);double-track syndrome was36.3%,33.3%and33.3%(P>0.05);patchyexudation was36.3%,16.7%and33.3%(P>0.05); moon bow sign was18.2%,50%and33.3%(P>0.05); crazy-paving pattern was13.6%,16.7%and33.3%(P>0.05). CT imaging:ground-glass opacities100%, nodular51.6%, pneumatocele41.9%, double-track syndrome35.5%, patchy exudation32.3%, thick interlobular septal32.3%, moon bow sign25.8%,crazy-paving pattern16.1%, real shadows3.2%, pleural effusion3.2%. The prone position:ground-glass and patchy exudation were mainly whole lobar distribution. Nodular mainly distributed the lower lobe of the lung, then the whole lung. Pneumatocele mainly distributedin upper lobe of the lung,then upper and middle lobe. Double-track syndrome were mainlywhole lung distribution, then upper lobe or upper and middle lobe. Moon bow sign mainlydistributed lower lobe. Crazy-paving pattern were mainly full lobar distribution. Coexistingsigns: Only one feature, two features,3features, more than4features are respectively6.5%,16.1%,35.5%and41.9%. Clinical outcome: For31patients, clinical cure rate was71%andnoneffective was29%.8cases which accounted for25.8%were tracked for3weeks.37.5%shadows were completely absorbed,62.5%shadows were dramaticlly absorbed. ConclusionCD4~+T cell count is associated with the pathogenesis of PCP, not distribution of imaging signs.CT imaging characteristics of PCP is diffuse symmetric distribution. The common signs areground-glass opacities, nodular, patchy shadows, crazy-paving pattern, pneumatocele,moonbow sign,thick interlobular septal and double-track syndrome.which have their owncharacteristics and distribution. PCP which is cured timely and effectively has a goodprognosis.Clinically, we must first consider the diagnosis of AIDS with PCP which thesecoexistence of CT image, especially young male patients.

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CLC: > Medicine, health > Internal Medicine > Infectious disease > Viral infections > Acquired Immune Deficiency Syndrome ( AIDS AIDS)
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