支气管内膜结核的CT诊断及鉴别诊断

CT Diagnosis and Differential Diagnosis of Endo-bronchial Tuberculosis

目的:探讨不同类型支气管内膜结核的CT表现,以提高对该病CT诊断和鉴别诊断水平。方法:回顾性分析经手术病理或纤支镜活检证实的17例支气管内膜结核的不同CT表现。结果:17例均有肺叶或肺段支气管起始部和/或分支部不同程度狭窄及管壁增厚,无肿块及反S征;其中,向心狭窄6例,偏心狭窄11例;狭窄伴肺叶或肺段不张12例,其中不张或实变区可见充气支气管征9例,占75%;伴胸腔积液8例;伴管腔内息肉样软组织影5例;伴肺内结核9例。结论:CT在支气管内膜结核的诊断及鉴别诊断中有重要作用。

Objective To investigate the CT findings of endo-bronchial tuberculosis （TB） in different types and to improve the diagnosis and differential diagnosis of this disease. Methods CT findings of endo-bronchial tuberculosis in 17 cases confirmed by pathology or fibro-bronscopy （FOB） were analysed retrospectively. Results The bronchi stricture can be seen at lobar bronchus or segmental bronchus and the bronchial walls were thickened. No mass and opposite ＂S＂ sign can be found in all the cases. Among them, centripetal stricture can be found in 6 cases, and eccentric stricture in 11 cases. Bronchi stricture with obstructive atelectasis in 12 cases. In which ＂Air bronchogram＂ can be found in 9 cases. Bronchi stricture with pleural effusion in 8 cases. With intrabronchial polypoid shadows in 5 cases. With active pulmonary TB in 9 cases. Conclusion CT scan is of important role in diagnosing and differential diagnosing endo-bronchial TB.