探讨胞内分枝杆菌型NTM肺病的临床与MSCT表现

发布时间：2018-04-29 06:44

本文选题：胞内分枝杆菌 + 非结核分枝杆菌　；参考：《临床放射学杂志》2017年07期

【摘要】：目的探讨胞内分枝杆菌非结核分枝杆菌(NTM)肺病的临床特点与CT征象。方法回顾性分析37例经临床确诊的胞内分枝杆菌型NTM肺病患者的CT资料与电子病历,并对其临床及影像学表现进行分析。结果37例患者最常见的临床症状为咳嗽咳痰,其次为咯血和活动后气促,约1/3患者原有继发型肺结核病史,1/3伴有慢性基础性肺病。最常见的CT表现为小叶中心结节即树芽征(97.3%),其次为支气管扩张(73.0%)、斑片状实变灶(54.1%)和纤维条索灶(43.2%),较少见的征象为厚壁空洞,仅见2个厚壁空洞病灶,且均位于右上肺。在合并支气管扩张患者中,右中叶和左舌叶出现支气管扩张的概率最高,分别达到56.8%和51.4%。纵隔和肺门淋巴结肿大和胸腔积液并不常见。结论胞内分枝杆菌型NTM肺病约1/3伴有慢性基础性肺病,主要CT表现为树芽征、支气管扩张、实变、结节和薄壁空洞,且支气管扩张好发于右中叶和左舌叶。
[Abstract]:Objective to investigate the clinical characteristics and CT signs of the pulmonary disease of Mycobacterium tuberculosis (NTM). Methods the CT data and electronic medical records of 37 patients with NTM lung disease confirmed by clinical diagnosis were analyzed retrospectively, and the clinical and imaging manifestations were analyzed. Results the most common clinical symptoms of 37 patients were cough and expectoration. Followed by hemoptysis and postoperative gas, about 1/3 patients had a history of primary pulmonary tuberculosis, and 1/3 was accompanied by chronic basic lung disease. The most common CT manifestations were the central nodule of lobules (97.3%), followed by bronchiectasis (73%), flaky solid foci (54.1%) and fiber stripe (43.2%). The rare signs were thick wall cavity, only 2 thick. In the patients with bronchiectasis, the probability of bronchiectasis in the right middle lobe and left tongue is the highest in the patients with bronchiectasis. The 56.8% and 51.4%. mediastinal and hilar lymph node enlargement and pleural effusion are not common. Conclusion the Mycobacterium type NTM lung disease is about 1/3 with chronic basic lung disease, and the main CT manifestation For tree buds, bronchiectasis, consolidation, nodules and thin walled cavities, and bronchiectasis occurs in the right middle lobe and left lingual lobe.

【作者单位】：长沙市中心医院放射科;湖南省人民医院放射科;
【分类号】：R563;R816.41

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