An animal experiment about early pulmonary candidiasis in immunosuppressive rabbits: thin-section CT images dynamically observed and proved by histopathological results
An animal experiment about early pulmonary candidiasis in immunosuppressive rabbits: thin-section CT images dynamically observed and proved by histopathological results
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DOI：
10.1258/ar.2011.100455
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发表时间：
2011-09
期刊：
影响因子：
1.3
通讯作者：
Li-xuan Xie;Shiyuan Liu;You-san Chen;Kai Liu;F. Xue
中科院分区：
文献类型：
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作者：
Li-xuan Xie;Shiyuan Liu;You-san Chen;Kai Liu;F. Xue
免疫功能低下患者肺部真菌感染的早期发现和治疗对死亡率有深远的影响。然而，关于念珠菌性肺炎的薄层计算机断层扫描（CT）结果的现有信息在很大程度上限于各种感染的回顾中观察到的孤立病例和免疫功能低下患者中观察到的其他急性肺部疾病。目的动态观察和评价免疫抑制动物肺念珠菌病急性期的CT表现。材料与方法24只新西兰大白兔随机分为实验组（n = 21）和对照组（n = 3）。肺念珠菌病由C.实验组经气管途径接种白色念珠菌，对照组经气管途径注射等量生理盐水。在接种/注射前和接种/注射后隔天进行胸部CT扫描。通过尸检获得微生物和病理学结果。结果实验组13只家兔经微生物学和病理学证实均成功建立肺念珠菌病模型。10只（10/13）家兔出现气腔实变区，6只呈小叶分布，4只呈小叶或节段性分布，病理表现为支气管扩张或出血性肺梗死。在5只（5/13）家兔中发现磨玻璃样阴影（GGO）区域，其中3只与其他异常相关，表现为支气管肺炎或间质性肺炎。3只（3/13）兔可见多发结节。2只兔的肉芽肿聚集在支气管血管束周围，1只兔的肉芽肿位于胸膜下，病理表现为出血性肉芽肿。其他不常见的CT表现包括支气管血管束增厚（n = 3），线性阴影（n = 1）和气胸（n = 1）。对照组3只家兔CT扫描及病理检查均未见异常。结论肺念珠菌病的早期薄层CT表现以周围多发小叶实变和/或GGO为多见。
Background Early detection and treatment of pulmonary fungal infection in immunocompromised patients has a profound impact on mortality. However, information available about the thin-section computed tomography (CT) findings of Candida pneumonia has largely been limited to isolated cases seen in reviews of various infections and to other acute lung diseases seen in immunocompromised patients. Purpose To dynamically observe and evaluate CT findings in immunosuppressed animals with histopathologically confirmed pulmonary candidiasis at the acute stage. Material and Methods Twenty-four New Zealand rabbits were randomly divided into an experimental group (n = 21) and a control group (n = 3). Pulmonary candidiasis was established by C. albicans inoculation via a transtracheal route in immunosuppressed rabbits in the experimental group, and an equivalent amount of normal saline was injected via the same way in the control group. Chest CT scan was performed before and on alternative days after inoculation/injection. Microbiological and pathological results were obtained by autopsy. Results In the experiment group, pulmonary candidiasis was successfully established in 13 rabbits as confirmed by microbiology and pathology. Areas of air-space consolidation were present in 10 (10/13) rabbits, with lobular distribution in six and lobar or segmental distribution in four, pathologically presenting as bronchopneumonia or hemorrhagic lung infarcts. Areas of ground-glass opacity (GGO) were identified in five (5/13) rabbits, three of which were associated with other abnormalities, presenting as bronchopneumonia or interstitial pneumonitis. Multiple nodules were seen in three (3/13) rabbits. They were clustered around bronchovascular bundles in two rabbits, and subpleural in the remaining one, pathologically presenting as hemorrhagic granulomas. Other less common CT findings included thickening of bronchovascular bundles (n = 3), linear opacity (n = 1), and pneumothorax (n = 1). No abnormality was detected by CT scan and pathological examination in the three rabbits of the control group. Conclusion Peripheral multiple areas of lobular consolidation and/or GGO representing bronchopneumonia were the most common thin-section CT findings of pulmonary candidiasis at the early stage.