以肺间质改变为主的不典型肺结核的CT特征分析

doi:10.3969/j.issn.1000-8535.2020.04.013

广州医药 ›› 2020, Vol. 51 ›› Issue (4): 59-63.DOI: 10.3969/j.issn.1000-8535.2020.04.013

以肺间质改变为主的不典型肺结核的CT特征分析

任会丽¹, 方伟军¹, 梁瑞云¹, 胡锦兴²

1 广州市胸科医院医学影像科(广州 510095)
2 广州市胸科医院结核科(广州 510095)

收稿日期:2020-03-27 出版日期:2020-07-20 发布日期:2021-11-28
通讯作者: 胡锦兴,E-mail:hujinixing2000@163.com
基金资助:
广东省中医药局面上科研项目(20191252);广州市高水平临床重点专科和培育专科建设项目(穗卫函[2019]155号)

The CT features of atypical pulmonary tuberculosis with pulmonary interstitial changes

REN Huili¹, FANG Weijun¹, LIANG Ruiyun¹, HU Jinxing²

1 Department of Radiology,Guangzhou Chest Hospital,Guangzhou 510095,China
2 The Department of Tuberculosis,Guangzhou Chest Hospital,Guangzhou 510095,China

Received:2020-03-27 Online:2020-07-20 Published:2021-11-28

摘要/Abstract

摘要： 目的探讨以肺间质改变为主的不典型肺结核的CT特征。方法收集2018 年1月—2018 年12月期间44例经我院临床及实验室确诊的以肺间质改变为主的不典型肺结核的CT影像学资料,进行归纳总结,分析其影像特点。结果 44例以肺间质改变为主的不典型肺结核其中14例患者在肺叶的分布呈局限性分布,其中主要分布于右肺上叶占13例;30例呈弥漫性分布;以间质改变为主的局限性分布及弥漫性分布的不典型肺结核均以细网织影、微结节、细支气管壁增厚、小叶间隔增厚为主要表现,树芽征、磨玻璃影在弥漫性分布中相对常见,其合并空洞、支气管扩张、纵膈淋巴结肿大钙化、胸膜炎、肺大疱的比例高于局限性分布患者;以肺间质改变为主的不典型肺结核呈局限性分布(14例)的患者预后良好,13例呈显著吸收,1例吸收良好;弥漫性分布(30例)的患者中,18例显著吸收,其中6例未吸收或吸收欠佳。结论以肺间质为改变为主的非典型肺结核具有其特征性,了解其CT特点有助于提高临床诊断及更好的评价治疗预后。

关键词: 间质, 肺结核, 体层摄影术

Abstract: Objective To discuss value of the CT features of atypical pulmonary tuberculosis with pulmonary interstitial changes and improve the early diagnosis of pulmonary tubeculosis. Methods The CT imaging data of 44 patients with atypical pulmonary tuberculosis with interstitial changes was collected from January 2018 to December 2018,and the imaging characteristics were analyzed. Results In 44 cases of atypical pulmonary tuberculosis,14 cases of atypical pulmonary tubeculosis were the localized distribution,13 cases were mainly in the right upper lobe,and 30 cases were diffuse distribution. The atypical pulmonary tuberculosis of the localized and diffuse distribution mainly with interstitial changes was characterized by tine reticular shadow,micnodule,thickening of bronchiole wall and thickening of interlobular Septa. Tree-bud sign and ground-glass shadow were common in diffuse distribution,and the proportions of cavity,bronchiectasis,mediastinal lymphadenopathy calcification,pleurisy and bullae were higher than that in localized distribution. The atypical pulmonary tuberculosis patients with localized pulmonary interstitial changes (14 cases) have a favourable prognosis,13 cases with significant absorption,1 case with favourable absorption,and 18 cases with the atypical pulmonary tuberculosis patients with diffuse pulmonary interstitial changes (30 cases) with significant absorption,6 cases with no absorption or poor absorption. Conclusion The atypical pulmonary tuberculosis with interstitial changes has its characteristics,and the CT features is helpful to improve the clinical diagnosis and better evaluation of treatment prognosis.

Key words: Interstitium, Pulmonary tuberculosis, Tomography

任会丽, 方伟军, 梁瑞云, 胡锦兴. 以肺间质改变为主的不典型肺结核的CT特征分析[J]. 广州医药, 2020, 51(4): 59-63.

REN Huili, FANG Weijun, LIANG Ruiyun, HU Jinxing. The CT features of atypical pulmonary tuberculosis with pulmonary interstitial changes[J]. Guangzhou Medical Journal, 2020, 51(4): 59-63.

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以肺间质改变为主的不典型肺结核的CT特征分析

The CT features of atypical pulmonary tuberculosis with pulmonary interstitial changes

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