新发肺结核病变的影像表现与误诊原因

The Analysis of the Imaging of the New-onset Pulmonary Lesions and Misdiagnosis

目的探讨新发性肺结核病变的影像学表现及误诊原因分析。方法筛选2013年1月至2014年1月我院收治的新发肺结核疾病患者80例作为研究对象,另选取80例复发活动性肺结核作为对照组。对所有患者进行螺旋CT胸部检查,总结新发肺结核病变的特异性征象,分析临床误诊原因。结果在对新发与复发肺结核影像结果对比中可发现纤维条索影、支气管扩张、肺气肿、钙化灶的表现及检出率存在显著差异,P<0.05具有统计学意义;在误诊原因主要以影像结果不典型造成的与肺炎等感染性疾病鉴别诊断错误。结论复发与新发肺结核CT均表现为小叶中心结节、树芽状、磨玻璃影、小叶样实变、空洞征,其中新发肺结核的纤维条索影、支气管扩张、肺气肿、钙化灶发生率较低,同时针对新发肺结核的诊断应结合病原学检查、痰结核菌及免疫学检查结果进行确诊,防止误诊、漏诊的发生。

ObjectiveTo investigate the imaging performance of the new-onset pulmonary lesions and Misdiagnosis.Methods Screened emerging disease 80 cases of tuberculosis patients in our hospital from January 2013 to January 2014 as research subjects, and the other to select 80 cases of recurrence of active pulmonary tuberculosis as a control group.Al patients was treated by spiral CT for chest examination, summarized emerging signs of TB disease specificity, and analyzed the clinical misdiagnosis.Results In the new and recurrent pulmonary imaging results could be found in comparing fiber cord shadow, bronchiectasis, emphysema, calcification of performance and detection rates were significantly different,P〈0.05 ,which was statisticaly significant; the main Misdiagnosis results were not typical in the image caused by pneumonia and other infectious diseases in the differential diagnosis errors.Conclusion CT pulmonary recurrence and new hair appears as centrilobular nodules, tree buds like, ground glass, like lobular consolidation, empty signs, in which the new hair of fiber cable video tuberculosis, bronchiectasis, emphysema, calcification has lower incidence of lesions, while the diagnosis of tuberculosis for new hair should be combined with pathologic examination, sputum examination results and immunological diagnosis, which is to prevent misdiagnosis occurred.