Analysis of CT signs in 21 cases of airway invasive pulmonary aspergillosis

HE Jiawei; XIE Yanghu; WANG Xiaoqiong; ZHOU Xuan; SHENG Mao; WANG Longsheng

doi:10.3969/j.issn.1673-3827.2024.02.006

Abstract：Objective To investigate the performance characteristics of computed tomography(CT)with airway-invasive pulmonary aspergillosis(IP A),in order to enhance the awareness of airway IP A and improve the diagnosis.Methods 21 patients with airway IPA treated in our hospital from August 2018 to June 2023 were divided into three types according to CT characteristics.Type Ⅰ involved the segmental and lobular bronchi,which manifested as bronchial wall thickening.The le-sion was further developed,type Ⅱ manifested as bronchiectasis and consolidation around the segmental and lobular bronchi.Type Ⅲ involved the bronchioles and pulmonary parenchyma,with bronchiolar wall thickening,tree-in-bud sign and acinar nodules around.Three types of CT signs and the differential diagnosis were analyzed in detail.Results 21 patients of airway IPA,3 patients(14.3% )had type Ⅰ,manifesting as thickening of lobular or segmental bronchial walls,some with tree-in-bud sign and acinar nodules around;11 patients(52.4% )had type Ⅱ,manifesting as segmental and lobular bronchiectasis and consolidation around the bronchus;and 7 patients(33.3% )had type Ⅲ,presenting as bronchiolar wall thickening,tree-in-bud sign,acinar nodules around and patchy blur.Conclusion Airway IPA has specific CT manifestations,and master its CT classification and characteristic signs,which is helpful for early clinical diagnosis and treatment.