艾滋病并发肺结核的影像学特征

Analysis of imaging features of AIDS patients complicated with tuberculosis

目的 探讨艾滋病合并肺结核的影像学特征.方法 回顾性分析2004年1月～2006年12月本院诊治的13例艾滋病合并肺结核患者胸部X线片及CT影像学特征.结果 临床分型：13例均为浸润型肺结核;影像学表现：胸部X线片以多发斑片状、片状渗出阴影,严重者有融合趋势及两下肺播散灶,CT为多叶段侵犯,片状阴影及腺泡样结节阴影并存,病灶中心浓密,周边模糊.结论 AIDS合并肺结核的胸部影像学特征多表现为多种性质的病灶共存,多形态、多叶段分布,以两下肺明显的渗出性、多形态病灶;纤维化、钙化、肿块样阴影少见,无典型的结核增殖灶、肺门淋巴结肿大、胸水产生与有关文献报道有异,可能与本组患者为年青人及免疫下降程度和病程发展不同阶段等因素有关.

Objective To summarize of features of imaging appearance of pulmonary tuberculosis （TB） among people living with HIV/AIDS so as to offer evidences for imaging diagnosis of the disease. Methods CT or/and X- ray appearances of chest in 13 eases suffered from AIDS complicated with tuberculosis from 2004 to 2006 were analyzed retrospectively, Results All of the 13 eases were infiltrative pulmonary tuberculosis and 4 of them showed multiple lobes of the lungs and 4 showed upper field or apex pulmonis and 5 cases showed lower field, Cendusion Imaging appearances of AIDS complicated with pulmoanry tuberculosis coexisted with multiple fcei of infection and polymorphism that distributed in multiple lobus. Most of AIDS patients were without typical tuberculous proliferative fcei and lyphadenectasis, possibly to be associated with decreasing extent of immune function and the progress of disease at various stages in the young patients observed.