支气管内膜结核的高分辨率CT诊断

Diagnosis of endobronchial tuberculosis with high-resolution CT scans

目的分析支气管内膜结核的高分辨率CT(HRCT)表现,提高对该病的影像诊断水平。方法回顾分析我院25例经支气管镜检和病理组织学证实的支气管内膜结核患者的临床及高分辨率CT资料。结果 HRCT显示左侧支气管受累者14例,其中左主支气管受累者6例,上叶支气管受累者3例,同时受累者5例。右侧支气管受累者9例,其中右主支气管及上叶支气管同时受累者6例,右中叶支气管受累者3例。双侧主支气管同时受累者2例。管腔狭窄远端肺组织肺不张15例,肺组织炎性实变2例,支气管播散11例,伴发肺内继发性肺结核13例。结论高分辨率CT能清晰显示支气管内膜结核的部位、直接征象及间接征象,因此能明显提高对其诊断的准确率。

Objective To analyze the high-resolution CT（HRCT） findings of endobronchial tuberculosis so as to elevate the diagnostic accuracy.Methods Clinical and CT data of 25 patients with endobronchial tuberculosis,confirmed by bronchoscopy and histopathology,were analyzed retrospectively.Results HRCT scans demonstrated that there were 14 left bronchial involvement（6 left main bronchi,3 left superior lobe and 5 above both）,9 right bronchial involvement（6 right main bronchi plus superior lobe and 3 right middle lobe） and 2 bilateral bronchial involvement among 25 patients.The lung atelectasis of distal stenosis segments was found in 15,inflammatory lung consolidation in 2,bronchial spread in 11 and secondary intrapulmonary tuberculosis in 13 cases.Conclusion HRCT may clearly show the locations,direct and indirect signs of endobronchial tuberoulosis and may greatly improve the diagnostic accuracy.