活动性肺结核肺间质病变的HRCT研究

High Resolution Computed Tomographic Findings of Interstitial Lesions of the Lung in Patients with Active Pulmonary Tuberculosis

目的探讨活动性肺结核肺间质改变的HRCT表现。资料与方法搜集肺部CT扫描以间质改变为主的活动性肺结核29例,分别在治疗前、治疗中和疗程结束时行HRCT检查,分析间质改变的影像特点及变化。结果肺结核间质病变好发于两上肺野,主要表现为片状蔓延和沿支气管树分布两种形式。小叶内间质异常是肺结核间质改变的主要HRCT表现,包括小叶内细网织线影、微结节、磨玻璃影、树芽征等,其发生率分别为100%(29例)、100%(29例)、82.8%(24例)、69%(20例)。此外可合并气道壁增厚、融合性实变、空洞、结节等征象。经抗结核治疗后间质病变吸收较缓慢,但在疗程结束时均大部分吸收。结论小叶内细网织线影、微结节、磨玻璃影、树芽征为活动性肺结核间质的主要HRCT表现。

Objective To evaluate high resolution computed tomographic （HRCT） findings of interstitial lesions of the lung in patients with active pulmonary tuberculosis. Materials and Methods HRCT findings before, during and after regular anti-tuberculosis treatment in 29 patients with active pulmonary tuberculosis predominantly involving interstitial tissues were analyzed. ResultsInterstitial abnormalities were found predominantly in bilateral upper lungs on HRCT. HRCT identified intralobular thin reticulation and micro-nodule in 29 cases（ 100% ）, ground-glass opacity in 24 cases（ 82.8% ） , and tree-in-bud sign in 20 cases （69%）. Thickening of bronchial wall, consolidation, cavity, and nodule were also revealed. All interstitial abnormalities diminished gradually at the late stage of anti-tuberculosis treatment. Conclusion Thin reticulation, micro-nodule, ground-glass opacity and tree-in-bud sign were frequent findings on HRCT in patients with active pulmonary tuberculosis.