肺非结核分支杆菌病的X线与CT影像分析  

X-ray and CT appearance of pulmonary nontuberculosis mycobacterial infection

作　　者：杨根东[1] 陆普选[1] 张莉萍[1] 李苑[1] 李少珍[1] 钟菊珍[1] 

机构地区：[1]广东省深圳市东湖医院放射科,广东深圳518020

出　　处：《中国医学影像技术》2008年第11期1789-1791,共3页Chinese Journal of Medical Imaging Technology

摘　　要：目的探讨肺非结核分支杆菌病的胸部X线和CT影像学表现。方法收集经确诊的28例肺非结核分支杆菌病的胸部数字化X线平片资料和其中22例的CT影像资料,回顾性比较、分析病变的影像学特点。结果病变位于两肺多叶者19例,单叶者9例;上叶受累26例,其中24例右肺上叶受累;18例中叶受累;6例下叶受累。病变通常以多种形态混杂存在,其中斑片状浸润影见于全部28例,纤维条索影20例,结节影15例,空洞13例,钙化3例,胸膜粘连肥厚23例,胸腔积液1例。CT扫描见支气管扩张13例,肺气肿或肺大泡11例,纵隔内淋巴结肿大3例。结论胸部X线平片是肺非结核分支杆菌病的首选检查方法。CT扫描对支气管扩张或纵隔内淋巴结肿大征象的显示更敏感。当影像学主要表现为两肺多叶多种病变形态混杂存在并且抗结核治疗无效时,应考虑本病可能。Objective To explore the chest X-ray and CT appearance of pulmonary nontuberculosis mycobacterial infection, so as to improve the diagnostic level of the disease. Methods The chest Xray findings of 28 patients with cultures positive for pulmonary nontubereulosis mycobacterium （NTMB） were reviewed, among 22 patients underwent CT scan. The findings of chest X-ray and CT were compared. Results The abnormalities involved bilateral multiple lobes （n= 19） or single lobe （n =9）. The upper lobes were involved in 26 patients, including 24 right upper lobes and 2 left upper lobes, while 18 middle lobes and 6 lower lobes were involved. Multiple manifestations often coexisted, including patchy consolidation （n= 28）, fibrosis （n=20）, nodule （n=15）, cavity （n=13）, calcification （n=3）, pleural adhesion and thickness （n=23）, and hydrothorax （n= 1）. Bronchiectasis （n = 13）, pulmonary emphysema or pulmonary bulla （n= 11） and mediastinal lymphadenopathy （n=3） were detected on CT, but not on chest X-ray. Conclusion The chest plain film is the first choice of pulmonary NTMB infection. CT is more sensitive than plain film in detecting bronchiectasis and mediastinal lymphadenopathy. When multiple coexisted manifestations involving bilateral multiple lobes and antitubereulous therapy being invalid, pulmonary NT- MB infection should be considered.

关 键 词：分支杆菌感染 肺疾病 体层摄影术 X线计算机 

分 类 号：R445[医药卫生—影像医学与核医学] R563[医药卫生—诊断学]