肺部感染性疾病CT树芽征的病因病理及其诊断价值

Pathogenesis and Value of Tree-in-bud at Diagnosis of Pulmonary Infections

目的:复习并探讨CT树芽征的病因病理和影像特点,评价其诊断价值。方法:对99例各类肺部感染性疾病行CT检查,对各类疾病树芽征的形态、部位及共存征象进行统计分析。结果:痰涂阳性肺结核、空洞性肺结核、慢性支气管炎合并感染及支气管扩张合并感染的树芽征出现率分别达到了90.0%、94.1%、88.9%及78.3%。边缘较锐利的树芽征出现在肺结核中。肺结核树芽征所在叶段支气管可表现无异常,慢性支气管炎合并感染及支气管扩张合并感染的树芽征所在叶段支气管均有异常表现。结论:肺结核树芽征有不同于其他肺部感染性疾病的形态及分布特点。

Objective To review the pathogenesis and analyze the value of the photographic character of tree-in-bud at diagnosis of pulmonary infections. Methods To check 99 pulmonary infections patients with CT and statistic the formation and location of tree-in-bud and the other signs at various pulmonary infections separately. Results The occurrence rates of tree-in-bud at smear positive and cavity pulmonary tuberculosis were 90.0% and 94. 1% respectively. The occurrence frequency of tree-in-bud in chronic bronchitis and bronchiectasis with secondary infection were 88. 9 % and 78. 3%. The margin of tee-in-bud being clear occurred only in pulmonary tuberculosis. Some of the lober,segmental or subsegmental level bronchi with tree-in-bud in the same lobe were normal in pulmonary tuberculosis. While at least one level of the bronchi with tree-in-bud in the same lobe were abnormal in chronic bronchitis or bronchiectasis with secondary infection. Conclusion The tree-in-bud sign in pulmonary tuberculosis has some characters different from the other pulmonary infections in the formation and location.