不典型肺结核的影像学误诊分析  

Analysis on Imaging Misdiagnosis of Atypical Pulmonary Tuberculosis

作　　者：郑浈浈[1] 董琼雄 黄映宏[1] 李仰康 郑瑜 吴仁华[1] 

机构地区：[1]广东省汕头市汕头大学第二附属医院放射科,515041 [2]广东省汕头市第三人民医院CT室 [3]广东省汕头市汕大附属肿瘤医院放射科

出　　处：《中华全科医学》2009年第1期91-92,共2页Chinese Journal of General Practice

摘　　要：目的分析影像学表现不典型的肺结核误诊的原因,总结不典型肺结核的X线与CT表现。方法49例误诊病例中男性30例,女性19例,年龄16～89岁。均行X线平片与胸部CT平扫,并与病理对照,找出误诊原因。结果49例肺结核误诊为肺癌29例,肺炎16例,其他疾病4例。误诊病例中影像学表现为结节和肿块病灶18例,肺段或肺叶阴影24例,肺门及纵隔肿块7例。结论影像学表现不典型、CT检查不全面及未与胸部平片表现综合分析是本组不典型肺结核误诊的主要原因。Objective To investigate X-ray and CT charaeteristics of atypical pulmonary tuberculosis and analyze the reasons of misdiagnosis in patients with atypical pulmonary tuberculosis. Methods The patients in this study included 30 man and 19 women,with ages ranging from 16 to 89 years old. Chest CT scans were performed in all patients. The CT films were contrasted with pathologic findings,so as to find the misdiagnosis reasons. Results 29 cases and 16 cases were mistaken for lung cancer and pneumonia, and 4 cases were diagnosed as other diseases by mistake. In misdiagnosed patients＇ CT films, 18 cases were noduses and masses,24 cases had pulmonary shadows,and 7 cases had masses in hilum lung and mediastinum. Conclusion The main causes of misdiagnosis of pulmonary tuberculosis are atypical radiological appearance on X-ray and CT films, and lacking of combination of CT findings with that of chest radiography.

关 键 词：肺结核 不典型 误诊 胸部X线 CT 

分 类 号：R521[医药卫生—内科学] R814[医药卫生—临床医学]