关键词: 结核.肺, 曲菌病, 支气管动脉造影

Abstract: Objective To study the pathogenesis of X ray imagings in contrast with pathologic changes in pulmonary aspergillosis.Methods The X ray findings of 51 cases with pulmonary aspergillosis and 28 cases pathologic results among them were retrospectively studied.Results The major X ray findings of pulmonary aspergillosis were as followes(1)parasitic pulmonary aspergillosis:there was aspergilloma shaped like a ball in the cavity of the underlying disease(38 cases).(2)allergic pulmonary aspergillosis:there was the underlying disease in one lobe in lung,and in another lobe there was bronchial mucus cast(“finger cover sign”).(3)invasive pulmonary aspergillosis:there were central necrosis in them.It was original pulmonary aspergillosis and there was no underlying disease in lung.Bronchial arteriography(BAG)demonstrated that there were common hyperplasias of bronchial arterial trunk and its branches(“blushs”),bronchial pulmonary arterial anastomoses(“shunts”),blooding focuses in the pulmonary parenchymal and bronchial arterial aneurysms,and so on. Conclusion (1)Radiographic features of aspergilloma are the important diagnostic bases in parasitic pulmonary aspergillosis.(2)Pulmonary tuberculosis can compicated with aspergillosis,but these tuberculoses were all cured and stable,which suggested that the treatment of pulmonary aspergillesis was the key.(3)Bronchial arteriography demonstrated that the pathologic basis of hemoptysis for pulmonary aspergillosis was the damage of bronchial artery.If embolization for hemoptysis is no effect,sugical resection should be considered.

Key words: Tuberculosis, pulmonary, Aspergillosis, Bronchial ateriography