70岁以上老年人肺结核的影像学表现

The medical imaging findings of pulmonary tuberculosis in old age of over 70 years

目的：探讨70岁以上老年人肺结核的影像学表现特点。方法：217例临床诊为肺结核的患者，年龄71—93岁，全部患者均摄有胸部X线片，其中79人进行了CT检查。对全部患者的影像学资料进行回顾性分析。结果：在本组中，病变累及两叶和两叶以上者163例（75．12％），中叶受累者59例（27．19％），病变累及下叶基底段者37例（17．05％），累及前段和舌段者79例（36．41％）。其中以纤维化病灶为主要表现者132例（60．83％）。有空洞者82例（37．79％），有结核球者21例（9．68％），有胸膜改变者122例（56．22％），CT发现肺门淋巴结肿大47例，纵隔淋巴结肿大59例，其中49例见有淋巴结钙化。结论：老年肺结核在病灶的分布范围、部位上不同于青壮年，其病灶性质以空洞和广泛纤维化为特点。

Objective：To detect the imaging features of pulmonary tuberculosis in old people. Methods：The X-ray and CT findings of 217 patients （age range： 71 - 93 years; mean age 77.8 years） with pulmonary tuberculosis were studied. Results： In these patients, the lesions were distributed in two or more than two lobes in 163 cases （75.12%）. The lesions were found in medial lobes of 59 eases （27.19%）. Basal segments of inferior lobe were involved in 37 eases （ 17.05% ） ; involving of anterior segment and lingua segment was foundin 79 cases （36.41%）. Flbrosis as the predominantly manifestation was seen in 132 eases （60.83%）. The cavity, pleural change, tuberculoma were found in 37.79%, 56.22%, 9.68%, respectively. Enlarged lymph nodes were found in hilum of lung of 47 cases, and in mediastimum of 59 cases by CT. Lymph nodes calcifications of these enlarged lymph nodes were appeared in 49 cases. Conclusion：The main imaging characteristics of pulmonary tuberculosis in old age included diffuse fibrosis and cavity. The old age was different from other people in position and distribution range of lesion.