老年肺结核的影像特征分析

Analysis on imaging manifestation of pulmonary tuberculosis in elderly patients

目的探讨老年肺结核的影像学特点,提高老年肺结核的诊断水平。方法回顾分析2006年6月—2012年7月80例老年肺结核的临床及影像学资料,全部患者均摄有胸部X线平片,其中30例进行了CT检查,8例增强。结果 80例中结核病灶在2个肺野以上的达77例(96.25%);多形态混合病灶并存47例(58.75%)。CT发现肺门淋巴结肿大21例,纵隔淋巴结肿大14例。经纤维支气管镜检查确诊29例,结核菌检查确诊13例,其余病例均经临床治疗及影像随访证实诊断。结论老年肺结核病灶性质在影像学表现以多叶受累,多形态影像并存为特点,CT检查优于X线平片。

Objective To study the features of X-ray and computerized tomography （CT） of pulmonary tuberculosis in elder pa- tients and try to improve its diagnostic level. Methods A total of 80 elderly patients with pulmonary tuberculosis between June 2006 and July 2012 were retrospectively analyzed in terms of clinical imaging data. All the patients were taken X-ray plain film, and 30 of them underwent CT including enhanced CT in 8 ones. Results Of the 80 patients, those whose involved lung field num- ber was not less than two accounted for 96.25% （77）, and those with multi-shaped foci accounted for 58.75% （47）. As for CT findings, there were 21 cases of hilar lymph node enlargement and 14 cases of mediastinal lymph node enlargement. Moreover, 29 cases were proved by microscopy and 13 cases by tuberculous bacteriology inspection. The other patients were proved by clinical treatment and delayed imaging manifestation. Conclusion The features in elder patients with pulmonary tuberculosis consist of the involvement of multi-lung fields and multi-shaped foci. CT is superior to X-ray plain film in the diagnosis of pulmonary tuberculosis in elderly patients.