肺非结核性分支杆菌病的X线和CT表现

X-ray and CT appearance of pulmonary nontuberculosis mycobacterial infection

目的 认识肺非结核性分支杆菌病的X线和CT表现。方法 回顾性分析经确诊的 2 2例肺非结核性分支杆菌病的X线胸片表现 ,其中 10例同时有CT扫描。记录异常所见和主要累及的肺叶 ;比较胸片和CT所见的异同。结果 胸片显示 :(1)全部病例都有病变 ;(2 )病变多数为两侧多叶分布 (17例 ) ,右侧比左侧多 (2 0∶16,) ,上叶比下叶多 (18∶15) ;(3 )在病变形态上斑片状实变 (19例 )、空洞(18例 )、纤维性变 (14例 )、结节 (12例 )是胸片上的主要表现 ;(4)多数病例 (19例 )多种病变同时出现。CT则以结节最常见 (10例均可见 ) ,其次为实变和空洞 ,各为 8例 ,此外尚可见 5例支气管扩张、3例“树芽征”和 2例纵隔淋巴结肿大 ,这些征象在胸片上均未能检出。结论 气腔实变、空洞、结节、纤维化是胸片的常见表现 ,在CT上还可见支气管扩张、“树芽征”和纵隔淋巴结肿大。该病变的形态和分布难以和继发型肺结核区别 。

Objective To study the ches t X-ray and CT appearance of pulmonary nontuberculosis mycobacteria (NTMB) Methods The chest X-ray findings of 22 cases with cultures positive for pulmonary nontuberculosis mycobacteria were reviewed, 10 cases had CT scans simultaneously All abnormalities and predominant lobar involvement were recorded The findings of chest X-ray and CT were compared Results The chest X-ray showed that air space consolidation ( n =19) and cavities ( n =18) were most frequently seen, nodules ( n =12) and linear disease ( n =14) were observed too The abnormalities involved bilateral multiple lobes, the right lung was more frequently involved than left, and upper lobe was involved more than lower ones Multiple manifestations were often co-existing ( n =19) On CT scans, nodule was the most frequent finding ( n =10), air space consolidation ( n =8) and cavity ( n =8) were other common findings In addition, bronchiectasis ( n =5), “tree in bud” sign ( n =3), and mediastinal lymphadenopathy ( n =2) were also seen on CT but not on chest X-ray Conclusion Air space consolidation, cavity, nodule, fibrosis, bronchiectasis, and “tree in bud” are major abnormalities of chest image The image abnormalities of pulmonary NTMB are indistinguishable from those of secondary pulmonary TB Multiple co-existing manifestations may be the characteristic findings of pulmonary NTMB infection