118例肺结核的不典型CT表现

发布时间：2018-03-07 06:13

本文选题：结核　切入点：肺　出处：《重庆医学》2014年19期 　论文类型：期刊论文

【摘要】：目的分析并总结肺结核的不典型CT表现,以提高对本病的诊断能力。方法回顾性分析118例不典型肺结核的胸部CT资料,包括发病部位、发病年龄及CT表现,所有病例均经痰检、活检或临床抗痨治疗有效证实。结果 (1)发病部位不典型15例(12.7%),其中位于右肺中叶4例,左肺上叶舌段3例,双肺下叶8例;(2)发病年龄不典型(即成人原发型肺结核)18例(15.3%),发病年龄为26~68岁,主要表现为纵隔或(和)肺门淋巴结肿大;(3)CT征象不典型85例(72.0%),孤立结节或肿块型47例,肺炎实变型10例,肺不张型6例,空洞型12例,多发结节型8例,磨玻璃密度型2例,以孤立结节或肿块型最为常见。结论肺结核的不典型CT表现多样,但仍有一定规律可循,充分认识和重视肺结核的不典型影像学表现,紧密结合临床,综合判断,以减少其误诊、漏诊率。
[Abstract]:Objective to analyze and summarize the atypical CT manifestations of pulmonary tuberculosis in order to improve the diagnostic ability. Methods the chest CT data of 118 patients with atypical pulmonary tuberculosis were retrospectively analyzed, including the location of the disease, age of onset and CT manifestations, all of which underwent sputum examination. Biopsy or clinical antituberculous therapy proved effective. Results 1) the site of the disease was atypical in 15 cases, including 4 cases in the middle lobe of the right lung, 3 cases in the left upper lobe of the lung, 3 cases in the left upper lobe of the lung, 4 cases in the middle lobe of the right lung. 8 cases of bilateral inferior lobes were diagnosed as having atypical age (18 cases of adult primary pulmonary tuberculosis and 15. 339%). The onset age was 26 ~ 68 years old. The main manifestations were atypical CT signs of mediastinal or / and hilar lymph node enlargement in 85 cases, solitary nodule or mass type in 47 cases. There were 10 cases of pneumonia, 6 cases of atelectasis, 12 cases of cavitation, 8 cases of multiple nodular type and 2 cases of grinding glass density type. In order to reduce the rate of misdiagnosis and missed diagnosis, we should fully recognize and attach importance to the atypical imaging manifestations of pulmonary tuberculosis, combine closely with clinical practice and make comprehensive judgment.
【作者单位】：重庆医科大学附属第一医院放射科;重庆市第五人民医院放射科;重庆涪陵妇幼保健院影像科;
【分类号】：R521;R816.41

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