Invasive pulmonary aspergillosis assisted in clinical diagnosis by chest CT pulmonary angiography: three cases report
10.3760/cma.j.cn121090-20250220-00082
- VernacularTitle:胸部CT肺血管造影辅助诊断侵袭性肺曲霉病：3例临床分析
- Author:
Dengmei TIAN
1
;
Jianhua YOU
;
Jiong HU
;
Ling WANG
Author Information
1. 上海交通大学医学院附属瑞金医院血液科，上海 200025
- Publication Type:Journal Article
- From:
Chinese Journal of Hematology
2025;46(10):972-976
- CountryChina
- Language:Chinese
-
Abstract:
Chest CT pulmonary angiography (CTPA) has certain auxiliary diagnostic value for the clinical diagnosis of invasive pulmonary aspergillosis (IPA) . Three patients with hematological malignancies were reported, including 2 ones after allogeneic hematopoietic stem cell transplantation and 1 ones after chemotherapy for refractory recurrent leukemia. Each patient was treated with antibiotics for at least 48 hours after the onset of fever, they all underwent chest high-resolution CT (HRCT) scans without fever resolution. CT revealed at least one dense pulmonary consolidation shadow with a diameter greater than 10 mm, and subsequently a CTPA examination was performed to observe the effect of CTPA imaging signs for the diagnosis of IPA. There were 2 patients with positive vascular occlusion sign (VOS) and 1 patient with negative VOS detected by CTPA. Among them, 2 patients with positive VOS were diagnosed with possible IPA and received with diagnosis-driven antifungal treatment, which improved their conditions. One patient with negative VOS sign was diagnosed with diffuse large B-cell lymphoma involving the lungs. After receiving anti-lymphoma treatment, the lesions significantly reduced in size. The vascular occlusion sign detected by CTPA is relatively characteristic. For high-risk IPA patients, it helps to improve the specificity of imaging diagnosis and guide clinical treatment decisions.
