CT对婴幼儿肺结核的诊断价值评估  

Evaluation of diagnostic value of CT in infant pulmonary tuberculosis

作　　者：陈建惠 方丽 章毅英[2] 朱传雷[2] 

机构地区：[1]浙江省诸暨市人民医院儿科,浙江诸暨311800 [2]浙江大学医学院附属儿童医院,浙江杭州310000

出　　处：《医学影像学杂志》2009年第6期679-681,共3页Journal of Medical Imaging

摘　　要：目的:评价CT在婴幼儿肺结核诊断中的价值。方法:收集近5年来经临床及病理证实的10例患儿的资料进行回顾性分析,其中男6例,女4例。年龄2月～3岁,小于1岁的6例;均采用GESytecSynergyCT机行胸部CT扫描。结果:肺内病变9例,CT显示肺部小颗粒状、斑片状密度增高影,病变范围广;空洞1例;1例伴肺内钙化。右侧病变明显多于左侧,上、中、下多有累及,以上叶为主;淋巴结肿大5例,CT显示1例轻度强化;淋巴结钙化4例,位于气管、支气管旁、肺门或纵隔,呈点状或环状高密度钙化灶;胸腔积液1例;胸膜增厚2例。结论:婴幼儿肺结核缺乏特异性,仅凭胸部X线摄片检查,极易出现误诊或漏诊,CT在婴幼儿肺结核的诊断及鉴别诊断中有着举足轻重的作用。Objective：To evaluate the value of CT in diagnosis of infant pulmonary tuberculosis. Methods： 10 pulmonary tuberculosis patients, which were eonfirrned by clinie and pathology in our hospital in past 5 years, were retrospectively analyzed in this work. Among these, there were six male patients and four fenmale patients. Ages were from two moths to three years. Six patients were less than one year. The thorax CT scan was performed using GE Sytec Synergy machinery. Results： CT showed nine patients with pathological lesions in lung, which exhibited small granular and high density patching image and, moreover, the lesions were extensive. One patient with cavity and another one with calcification in lung were found, respectively. Right-side pathological changes were more obvious than those of left. The lesions involved in almost the whole lung, with the severity in the upper lobe. Lymphadenopathy was found in five patients, of which lymph node calcification was four eases and slighdy enhancement was found in one case that were located in the trachea, bronchia, hilum of lung, and mediastina. The nodes presented with multiform and circular high density calcification. Pleural effusion was found in one and pleural thickening in two eases. Conclusion： Infant pulmonary tuberculosis is lack of specificity. If only according to chest X-my examination, it would lead to misdiagnosis. CT plays key roles in the diagnosis and differential diagnosis of infant pulmonary tuberculosis.

关 键 词：肺结核 影像诊断 婴幼儿 体层摄影术 X线计算机 

分 类 号：R529.9[医药卫生—内科学] R814.42[医药卫生—临床医学]