肺间质病变继发性肺结核患者的高分辨率CT特征探讨

Exploration of High-Resolution CT Features of Patients with Secondary Pulmonary Tuberculosis Caused By Pulmonary Interstitial Lesions

目的 探讨肺间质病变继发性肺结核患者的高分辨率CT(HRCT)特征。方法 选取2018年1月—2023年5月在本院治疗肺部间质性病变或感染的过程中发现继发肺结核患者15例,肺间质病变继发性肺结核患者均进行HRCT检测,分析其病变部位及分布特点等。结果 HRCT显示肺间质病变继发性肺结核患者病变部位多见于肺上叶,共累及87个肺段,其中左、右肺上叶尖后段病变占比较高;在CT扫描中,病灶表现为磨玻璃样阴影或细网织线阴影,边界清晰,HRCT显示肺小叶间质出现异常情况。其中,细微结节及小叶内细网织样阴影的检出率为100%。结论 HRCT检查能更加清晰地显示肺间质病变、其肺小叶内的微小病变,病灶好发部位、形态学特点,能作为鉴别本病与其他间质肺部疾病的可靠依据。

Objective To explore high-resolution CT features of patients with secondary pulmonary tuberculosis caused by pulmonary interstitial lesions.Methods The paper chose 15 patients with secondary pulmonary tuberculosis with treatment of pulmonary interstitial disease or infection in our hospital from January 2018 to May 2023,including 10 males and 5 females.All cases with secondary pulmonary tuberculosis caused by pulmonary interstitial disease were detected by high-resolution CT.Results HRCT showed that the lesions of patients with secondary pulmonary tuberculosis were mostly located in the upper lobe of the lungs,involving 87 lung segments,with a higher proportion of lesions in the posterior apex of left and right upper lobes;In CT scans,the lesion appears as ground glass like shadows or fine mesh like shadows with clear boundaries.HRCT shows abnormal conditions in the interstitial space of pulmonary lobules,with a detection rate of 100% for fine nodules and fine mesh like shadows within lobules.Conclusion In HRCT examination,pulmonary interstitial lesions can be more clearly displayed,and the small lesions within the pulmonary lobules,the prone areas of lesions,and morphological characteristics can serve as a reliable basis for distinguishing this disease from other interstitial lung diseases.