非常见部位肺结核的CT诊断

CT Diagnosis for Pulmonary Tuberculosis on Unusual Position

目的 回顾性分析非常见部位肺结核的CT表现，提高CT对非常见部位肺结核的诊断及鉴别诊断能力。方法 52例非常见部位肺结核（均经痰结核菌阳性、手术或穿刺活栓病理证实）进行了常规胸部平片及CT扫描检查，其中28例还作了高分辨率CT（HRCT）扫描，9例团块状病灶作了增强扫描。结果 CT表现为多形性病变：腺泡结节状病变43例、渗出及实变36例、纤维化28例、钙化14例、空洞9例、团块状病灶（结核球）9例、胸膜改变48例。所有病例均有两种或两种以上病变并存，83％～92％病例伴有腺泡结节状病变或／和局限性胸膜肥厚粘连。结论 非常见部位肺结核的CT表现具有一定特征，结合临床资料，大部分病例CT可作出正确的诊断。

Objective To analyze respectively CT appearances of pulmonary tuberculosis on unusual position , and to improve the ability of CT diagnosis and differential diagnosis. Methods 52 cases of pulmonary tubereulosis on unusual position were performed by chest X - ray fihn and thoracic CT scan, and among them, 28 cases by HRCT, 9 cases with masses by contrast enhancement. All cases were confirmed by positive tubercle bacilli of sputum or operation and puncture biopsy pathologically. Results CT appearances were pleomorphism： there were acinus nodules lesions （ n = 43 ）, exudation and consolidatinon （ n = 36 ）, fibrosis （ n = 28 ）, calcification （ n = 14 ）, cavity（ n = 9 ）, mass（ tuberculoma ） （ n = 9 ）, pleural lesion （ n = 48 ）. All the cases had simultaneously two or more lesions, and 83 - 92% cases were accompanied with gland alveolar nodules and local pleural thickening and adhesion. Conclusion The pulmonary tuberculosis on unusual position had a certain CT characteristics, and combined with clinical data, most cases could be correctly diagnosed.