胸膜结核球的影像学表现  

The Imaging Manifestations of Pleural Tuberculoma

作　　者：邓东[1] 黄仲奎[1] 龙莉玲[1] 叶伟[1] 梁秀咸[1] 梁登成[1] 黄践[1] 

机构地区：[1]广西医科大学第一附属医院放射科,广西南宁530021

出　　处：《实用放射学杂志》2005年第7期692-694,共3页Journal of Practical Radiology

基　　金：广西科学基金资助项目(桂科基0342036)。

摘　　要：目的探讨胸膜结核球的影像表现,以提高对其认识。方法回顾分析23例,其中11例经手术病理证实,4例伴有肺结核和8例病变同侧结核性渗出性胸膜炎。经治疗随访确诊胸膜结核球的X线平片表现,其中CT检查18例和MRI检查6例。结果23例中X线胸部平片呈圆形9个,椭圆形6个,病灶密度均匀,边缘清楚。CT检查18例,胸膜病灶形态为乳头状6例,卵圆形11例,1例形状不规则。CT平扫呈等密度11例,稍高密度5例,混杂密度2例。病灶边界清楚13例,部分模糊5例。6例MRI检查的病例形态为乳头状形4例,卵圆形2例。其中病灶表现为T1WI上呈略低信号,T2WI上中等或略高信号,增强后病灶显著均匀增强2例;病灶表现T1WI上呈低、等信号,T2WI上略高或混杂信号,增强后病灶中央呈低信号,周边呈薄壁环形强化4例。结论X线平片检查可作为发现病变的首选方法,而该病CT及MRI检查的表现较具特征性。Objective To study the imaging manifestation of pleural tuberculoma.Methods X-ray findings of plearal tuberculoma in 23 cases confirmed by pathological examination,tubercule bacillus from thorax liquid,or by follow-up study of tuberculotherapy were analysed retrospectively.Of the 23 patients,18 underwent CT examination,and 6 underwent MRI examination.Results On 23 X-ray images,9 focuses were round and 6 were ellipse.The density of the focuses was uniform,and their margins were shape.CT scanning on 18 cases showed low density in 11 cases,a little higher and even density in 5 cases,and intermixed densities in 2 cases.Focus shape was papillary in 6 cases,oval in 11 cases,and irregular in one case.More shape margins of the focus were found in 13 cases,and unshape in 5 cases.Of 6 cases,MRI examination showed papillary focuses in 4 cases and oval in 2 cases.The signal of the lesion in 2 cases showed lower or moderate on T1WI and a little higher intensified on T2WI.4 cases showed mainly lower signal on T1WI and a little higher or mixed signals on T2WI.Contrast enhanced MR showed lower signal at the center and ring enhanced in 4 cases.Conclusion X-ray image is the prime choice to confirm the location and range of pleural tuberculoma while CT and MRI is of characteristic findings of pleural tuberculoma.

关 键 词：结核球 胸膜 X线摄影术 体层摄影术 X线计算机 磁共振成像 

分 类 号：R561[医药卫生—呼吸系统] R814.42[医药卫生—内科学]