涂阴老年不典型肺结核的多种CT影像表现

Different CT imaging manifestation of elderly smear-negative patients with atypical pulmonary tuberculosis

目的探讨涂阴老年不典型肺结核的多种CT表现。方法收集我院住院的经临床治疗、痰检及纤支镜证实的涂阴老年不典型肺结核30例,就其CT表现回顾性分析。结果 1大片状肺实变影3例(占10%);2单发球形或肿块2例(占6.7%):1例结核球;1例肿块;3多发结节及肿块:2例(占6.7%);4间质改变11例(占36.7%);5空洞征3例:薄壁空洞1例(占3.3%),厚壁空洞2例(占6.7%);6树芽征6例(占20%);7磨玻璃影3例(占10%)。结论胸部CT扫描可识别涂阴老年不典型肺结核的多种征象,判断病变的性质和程度等方面具有较高的敏感度,有助于评价和监测不典型继发性肺结核的诊断、征象的转归等演变过程,为临床提供不可或缺的支持。

Objective To investigate the different CT imaging manifestation of elderly smear-negative pa-tients with atypical pulmonary tuberculosis. Methods 30 elderly smear-negative patients with atypical pulmonary tu-berculosis who underwent CT were included, and their CT imaging manifestation were reviewed. Results There were 3 cases of consolidation （10% ）, 2 cases of single spherical or mass （6. 7% ）, 2 cases of multiple nodules and mas-ses （6. 7% ）, 11 cases of interstitial change （36. 7% ）, 3 cases of hole （including 1 case of thin walled cavity and 2 cases of thick walled cavity）, 6 cases of tree-in-bud （20% ）, and 3 cases of ground glass shadow （10% ）. Conclu-sion CT findings can improve the specificity of images for elderly patients with smear-negative atypical pulmonary tuberculosis.