气管、大支气管结核的影像学诊断

X-ray Diagnosis of Tuberculosis of the Trachea and Large Bronchus in Adults

对35例成人气管、大支气管结核进行了临床分析。本组病例以青年女性居多。多数患者胸片有或多或少或新或旧的结核灶或支气管播散灶。35例均有不同程度的管腔狭窄,病变范围较长,支气管多部位受累。左侧多于右侧。管腔高度狭窄至阻塞者22例,其中狭窄伴有变形者12例。管腔内缘显示光滑或呈轻度锯齿或波浪状改变。狭窄周围无明显包块。只有依靠支气管体层或造影摄影才能显示直接征象。笔者还分析了误诊原因,讨论了诊断与鉴别诊断。

35 cases of tuberculosis of the traches,and main bronchus were analyzed clinically and radiographically.Young females predominated.The chest films of most patients showed tuberculous lesion either focal or extensive ,old or new, sometimes with bronchogenic spread.All 35 cases had stenosis of the lumen ,involving a long segment and multiple foci frequently in the trachea. The left side was involved more than the right side.22cases had marked stenosis or obstruction and in 12 cases,stenosis was accompanied by deformation twisting and shortening.The inner borderof the lumen was smooth or slightly serrated.No mass was found surrounding the stenosed segment.Only bronchial tomograply orbronchography could directly visualize the lesion.The diagnosis, diferential diagnosis and the causes of misdiagnosis were discussed.