肺结核不典型CT表现误诊分析

Analysis of misdiagnosis of atypical CT appearances of pulmonary tuberculosis

目的 :对肺结核不典型的CT影像特点进行分析以总结误诊原因。方法 :2 4例肺结核均行CT平扫 ,其中 2例做增强扫描 ,全部经临床或病理确诊。结果 :按CT表现分 3型 :①结节 /肿块型 16例 ,边缘光滑者 9例 ,毛糙者 4例 ,浅分叶 3例 ;②片状实变型 5例 ,形态不规则 ,密度均匀 ,边缘模糊 ;③肺不张型 3例 ,表现为叶或段支气管狭窄或闭塞 ,肺组织体积缩小。结论 :肺结核的发病出现新趋势 ,老年结核增多。其影像表现多样 ,应根据各种征象进行综合分析 。

Objective:To investigate the atypical CT appearances of pulmonary tuberculosis,and to analyse the causes of misdiagnosis.Methods:24 cases of pulmorary tuberculosis were performed CT plain scans,two of them also were performed CT enhanced scanning.All of the cases were confirmed by clinical results or pathology.Results:The CT findings were classified into three types:①nodule or mass type(n=16):the edge was smooth (n=9),ill defined(n=4) and lobular (n=3);②patchy consolidation type(n=5):this appeared irregular with homogeneous density and ill defined edge;③atelectasis type(n=3):this showed stenosis or occlusion of the lobar or segmental bronchus with the collapsed lung.Conclusion:The episode of pulmonary tuberculosis presents a new tendency of the increasing incidence in the elderly.CT findings are variable.Thus,a comprehensive analysis of all imaging features is necessary for avoiding misdiagnosis.