糖尿病合并肺结核的影像表现(附112例分析)

Radiological manifestation of pulmonary tuberculosis complicated with diabetes mellitus: analysis of 112 patients.

目的分析糖尿病合并肺结核的X线及CT的影像表现,提高对本病影像学的认识。方法收集2004年2月至2006年2月收治的糖尿病合并肺结核患者112例,分析其病灶的形态特点,分布特点,初诊诊断肺结核的准确率。结果112例患者中,病灶位于双肺上叶尖、后段和/或下叶背段者69例,占61.6%,初诊正确率达78%;位于右肺中叶和/或左肺上叶舌段者30例,占26.8%,初诊正确率约36%,位于一侧和/或双肺上叶前段、双下肺叶基底段者13例,占11.6%,初诊正确率约31%。;表现为大片状病灶者48例,占42.8%,斑片状病灶、部分融合者74例,占57.2%,合并空洞者76例,占67.8%,常伴有支气管播散灶。结论糖尿病合并肺结核具有一定的影像学特征:以炎性渗出、干酪变质为主,空洞发生率高,糖尿病合并肺结核于结核非好发部位的发病率高,初诊正确率低。

Objective To analyze the radiographic and CT appearances of pulmonary tuberculosis complicated with diabetes mellltus and improve the comprehension of its imaging features. Methods 112 in - hospital patients with pulmonary tuberculosls compllcated with diabetes mellitus were included from February 2004 to February. The morphologlcal distribution features of the pulmonary tuberculosls lesions were analyzed. The diagnostic accuracy of initial radialogical examination was obtained. Results In 112 patients, the lesions of 69 patients （61.6%） were found located in apical and posterior segments of bilateral upper lobe or back segments of the lower lobe. The initial diagnostic accuracy was 78%. The lesions of 30 patients （26.8%） were found in the right middle lobe and/or the lingual segment of left upper lobe with an initial diagnostic accuracy of 36%. The lesions of the remaining 13 patients （ 11.6% ） were found unilateral and/or bilateral anterior segment of the upper lobe and bilateral basal segment of lower lobe, the initial diagnostic accuracy was 31%. The large consolidation lesions occurred in 48 patients （42.8%） and patchy lesions with partially confluence occurred in 74 patients （57.2%）. In 76 patents （67.8%）, the lesions were complicated with cavitations and frequently with bronchus dissemination. Concussion The imaging findings of pulmonary tuberculosis complicated with diabetes mellitus is somewhat characteristic. The lesions were mainly inflammatory effusion and classification with a high occurrence of cavitations. The lesions also frequently occurred in the locations unusually for pulmonary tuberculosis with a low initial radiological diagnostically accuracy.