以肺间质改变为主肺结核HRCT特征分析

发布时间：2018-04-01 09:34

  本文选题：肺疾病　切入点：肺间质病变　出处：《放射学实践》2017年04期

【摘要】：目的:探讨以肺间质改变为主的肺结核HRCT表现,提高其影像诊断水平。方法:回顾性分析100例已确诊为肺结核患者的影像学资料,所有患者以肺间质改变为主,总结这类患者的HRCT特点。结果:100例中病变共累及361个肺段,右肺上叶尖段和后段(52例,14.4%)、左肺上叶尖后段(48例,13.3%)、右下叶基底段(53例,14.9%)和左下叶基底段(51例,14.1%)是主要受累部位。病变在双肺弥漫性分布35例。将所有病变按部位(好发部位和非好发部位)分为2组,好发部位组中病变沿叶段中央分布共151个肺段(44.9%),叶间胸膜旁分布112个肺段(33.3%),明显多于胸膜下分布的73个肺段(21.7%);非好发部位组中沿叶段中央分布共86个肺段(31.5%),叶间胸膜旁分布79个肺段(28.9%),胸膜下分布108个肺段(39.6%);两组间差异有统计学意义(χ~2=24.037,P0.001)。按间质类型分析:轴心间质异常69个肺段(23.7%);周围间质异常125个肺段(42.9%);间隔间质异常97个肺段(33.3%)。伴发改变:磨玻璃样影(GGO)48例,实变30例,支气管播散7例,微结节32例,空洞12例,肺大疱18例,气胸2例。本组病例中经规则抗结核治疗后间质病变明显吸收者31例(31%),稍有吸收者23例(23%),无明显吸收者46例(46%)。结论:以肺间质改变为主的肺结核的HRCT表现具有一定特征性。
[Abstract]:Objective: to investigate the HRCT findings of pulmonary tuberculosis with pulmonary interstitial changes and to improve its imaging diagnosis. Methods: the imaging data of 100 patients with pulmonary tuberculosis were analyzed retrospectively. The HRCT features of these patients were summarized. Results in 100 cases, 361 lung segments were involved. There were 52 cases with right superior lobe apex and posterior segment, 48 cases with left superior apex posterior segment, 53 cases with right inferior lobe basal segment and 51 cases with left inferior lobe basal segment. (predilection and non-predilection) were divided into two groups, A total of 151 lung segments were distributed along the center of lobar segment in the predilection group, 112 lung segments were distributed beside the interlobar pleura (33.3%), significantly more than the 73 lung segments distributed under the pleura (21.775%); in the non-predilection group, 86 lung segments were distributed along the center of the lobar segment, and the interlobar area was 31.5%. Seventy-nine lung segments were distributed around the pleura and 108 under the pleura. The difference between the two groups was statistically significant (蠂 ~ (2) 2) 24.037 (P 0.001). According to the type of interstitial, 69 lung segments were abnormal in axonal stroma, 42.9m in peripheral interstitial abnormalities, and 97 in septal interstitial abnormalities. Accompanied by changes: 48 cases of GGOA with glass-like opacity, There were 30 cases of consolidation, 7 cases of bronchial dissemination, 32 cases of micronodule, 12 cases of cavity, 18 cases of pulmonary bullae. 2 cases of pneumothorax. In this group, 31 cases had obvious absorption of interstitial lesion after regular anti-tuberculosis treatment, 23 cases had slight absorption, 46 cases had no obvious absorption. Conclusion: pulmonary tuberculosis with pulmonary interstitial change is characterized by HRCT.
【作者单位】： 武汉市肺科医院放射科;
【分类号】：R521;R816.41
，

本文编号：1694972