系统性红斑狼疮相关性肺结核的CT诊断  

CT Diagnosis of Pulmonary Tuberculosis Associated with Systemic Lupus Erythematosus

作　　者：吴华伟[1] 程杰军[1] 许建荣[1] 华佳[1] 顾海燕[1] 邹爱华[1] 杨咏琰[1] 

机构地区：[1]上海第二医科大学附属仁济医院放射科,200001

出　　处：《中国医学计算机成像杂志》2004年第4期236-238,共3页Chinese Computed Medical Imaging

摘　　要：目的 :初步评价肺结核在系统性红斑狼疮中的CT表现特点及CT诊断价值。材料和方法 :回顾性分析557例系统性红斑狼疮病人 (均有激素治疗史 ) ,合并活动性肺结核31例 ,行肺部CT扫描 ,结合临床资料分析肺结核的CT表现。结果 :肺结核在系统性红斑狼疮中的发病率为5.6%。其中粟粒性肺结核9例 (29.0 % ) ,肺门和纵隔淋巴结肿大11例 (35.5% ) ,结核性胸腔积液7例 (22.6 % ) ,空洞伴两肺气道播散3例 (9.7 % ) ,两上肺索条状、结节状浸润灶5例 (16.1 % ) ,两肺弥漫实变灶、磨玻璃影2例 (6.5% )。结论 :系统性红斑狼疮相关性肺结核的发病率高 ,CT上以粟粒性肺结核、淋巴结肿大和胸腔积液表现为主 ,反映了机体对结核杆菌的免疫低下。Purpose:To evaluate preliminarily the CT manifestations and CT value of pulmonary tuberculosis in paˉtients with systemic lupus erythematosus.Materials and Methods:Thirty-one patients with active pulmonary tuberculosis among557patients diagnosed with SLE were analyzed retrospectively.All paˉtients received steroid therapy since the diagnosis of SLE.The CT scans were reviewed with clinical information.Results:Pulmonary tuberculosis associated with systemic lupus erythematosus had an inciˉdence of5.6%.Miliary tuberculosis was found in nine patients(29.0%).TB lymphadenopathy in the hilar and mediastinal station was noted in eleven patients(35.5%).Seven patients(22.6%)showed pleural efˉfusions.Cavitary lung lesions with bronchogenic spread to the contralateral lung(n=3,9.7%)and stready and nodular opacities in upper lung zones(n=5,16.1%)were also seen.Two patients(6.5%)showed diffuse consolidation and ground-glass opacity.Conclusion:The prevalence of pulmonary tuˉberculosis is high in patients with systemic lupus erythematosus.Imaging of these patients showed mainly miliary tuberculosis,lymphadenopathy and pleural effusions.These findings may reflect impaired immune response against tuberculous bacilli.

关 键 词：系统性红斑狼疮 粟粒性肺结核 CT诊断 相关性 CT表现 发病率 淋巴结肿大 空洞 

分 类 号：R816.4[医药卫生—放射医学]