不典型肺结核的CT影像学诊断

CT Imaging Diagnostic Analysis of Atypical Tuberculosis

目的:通过对不典型肺结核影像学特征的探讨及分析,提高对该病诊断及鉴别诊断准确率。方法:回顾分析信宜市人民医院2008年1月至2016年3月诊治的60例不典型肺结核病例的临床及影像学资料,观察不同类型不典型肺结核病的计算机断层扫描(CT)影像诊断情况,分析CT影像诊断特点。结果:60例不典型肺结核CT表现大致可分为6种类型:(1)结节或肿块型30例。(2)节段或肺叶实变型13例。(3)空洞型7例。(4)纵膈淋巴结肿大型3例。(5)支气管内膜结核5例。(6)间质改变为主2例。结论:不典型肺结核影像表现较为复杂,特征较多,影像诊断医师在对不典型肺结核进行分析诊断时,要注意排除其它疾病诊断,还应结合临床症状及相关实验室检查进行进一步确认,并对病灶进行动态观察,以提高不典型肺结核的诊断率。若无法确诊,应尽早对其病变组织进行活检。

Objective Through the analysis of atypical diagnosis and differential diagnosis of the disease accuracy. pulmonary tuberculosis imaging features, analysis, improve the Methods The clinical and imaging data of 60 cases of atypical tuberculosis were retrospectively analyzed. The CT imaging of different types of atypical tuberculosis was observed and the characteristics of CT imaging were analyzed. Results 60 cases of atypical tuberculosis CT manifestations can be roughly divided into six types： （1） nodules or masses of 30 patients （2） segment or lung solid variant 13 cases; （3） hole type 7 cases; （4） of mediastinal lymph nodes swollen large 3 cases; （5） bronchial endomctrial tuberculosis in 5 cases （6） interstitial change primarily in 2 cases. Conclusions Atypical pulmonary tuberculosis imaging performance is more complex, more features, imaging diagnostic physicians in the diagnosis of atypical pulmonary tuberculosis diagnosis, should pay attention to the exclusion of other diseases, should also be combined with clinical symptoms and related laboratory tests to further confirm. Dynamic observation of the lesion were taken to improve the diagnosis of atypical tuberculosis. If can not be diagnosed, biopsy of its diseased tissue should be performed as soon as possible.