孤立干酪结节性肺结核的X线、CT分析

X-ray and-CT Scan Analysis of Solitary Caseous Nodule Pulmonary Tuberculosis

目的:探讨直径小于1.5 cm孤立干酪结节性肺结核的X线、CT表现及诊断特点。方法:回顾性分析49例具有完整临床资料的孤立干酪结节性肺结核病人的X线、CT表现。结果:49例中,主要表现为边缘光滑18例、毛糙31例、钙化21例、空洞15例、胸膜粘连11例、卫星病灶38例、支气管血管集中18例,20例增强扫描中9例轻度强化,多呈环状。结论:钙化、卫星病灶、强化特点是孤立干酪结节性肺结核的主要诊断依据。应用CT,尤其是HECT扫描,结合随访及穿刺活检,大多数病例可以得出正确诊断。

Objective：To discuss the imaging manifestation and diagnostic characteristics of the solitary caseous nodule pulmonary tuberculosis with the diameter less than 15 cm. Methods：Fortynine patients with the solitary caseous nodule pulmonary tuberculosis were included in this study. Results：The main X-ray and-CT appearances of 49 cases included. Smooth edge （18 cases） , shaggy or and coarse Spiculate （31 cases）,calcifications （21 cases）, cavitary nodule （15 cases）, Pleura adhesion （11 cases）,satellite （38 cases）,and bronchiolar and blood vessel centralize（18 cases）, 9 of 20 cases showed minimal enhancement. Conclusion：Some specific CT features,including calcifications, satellite, minimal enhancement, are primary basis for diagnosis of the solitary caseous nodule pulmonary tuberculosis. Most cases could be diagnosed by CT scan, especially HRCT,integrate the follow-p and needle biopsy.