不典型肺结核临床及CT影像特征分析

目的探讨不典型肺结核的临床及影像特征。方法回顾性分析52例经临床确诊的不典型肺结核患者的临床资料及CT影像特征,观察肺内病灶的大小、形态、位置、有无合并肺门淋巴结肿大及有无肺外结核。结果病灶位于上叶13例,中叶9例,下叶14例,两肺多发16例;呈肿块状4例,结节、斑片及索条48例;合并空洞11例;合并肺门淋巴结肿大13例;伴有肺外结核4例。结论不典型肺结核多位于不典型部位,表现为结节肿块状,斑片、肺叶实变及空洞,伴有或不伴有肺门纵隔淋巴结肿大,充分认识这些影像特征并结合临床资料可提高临床诊断准确率。

Objective To investigate the clinic and CT features of atypical pulmonary tuberculosis.Methods The clinical data and CT imaging features of 52 patients diagnosed pulmonary tuberculosis were retrospectively analyzed.The size,shape,location of the lesion,the presence of hilar lymph node enlargement and the presence of extrapulmonary tuberculosis were observed.Results The lesions were located in upper lobe in 13 cases,middle lobe in 9 cases,lower lobe in 14 cases,and multiple lung lesions in 16 cases.4 cases were lump-like,48 cases were nodules,patches and strips,11 cases were combined with cavities.13 cases were complicated with hilar lymph node enlargement.4 cases were accompanied by extrapulmonary tuberculosis.Conclusion Atypical pulmonary tuberculosis is mostly located in atypical sites and presents as nodular masses,plaques,solid lobe changes and cavities with or without hilar mediastinal lymph node enlargement.It would improve the accuracy of clinical diagnosis by recognizing the imaging manifestations and combining with clinical data.