肺结核初治中的类赫反应CT影像分析  

The Similar Hexheimer Reaction during Initial Treatment of Pulmonary Tuberculosis. CT Appearances

作　　者：吕岩[1] 周新华[1] 谢汝明[1] 徐金萍[1] 

机构地区：[1]北京市结核病胸部肿瘤研究所放射科

出　　处：《结核病与胸部肿瘤》2009年第3期214-217,共4页Tuberculosis and Thoracic Tumor

摘　　要：目的探讨肺结核初治中类赫反应的CT特征。方法回顾性分析44例经临床证实的肺结核初治中出现类赫反应患者的CT资料，治疗前后均经CT平扫、薄层及高分辨CT扫描，17例行CT增强扫描。结果全部患者按发病部位共57处统计例数，表现为肺内病变进展（原发病变范围扩大或新发片状影、胸膜下球形影）28例，胸膜病变（胸腔积液、胸膜结核球）10例，心包增厚1例，淋巴结肿大15例，胸腺反应3例。发生时间为20d至3．5个月，最短出现时间为20d；继续原方案治疗1．0～3．0个月病变好转或消失，其中3．0个月内消失37例（84％）。结论类赫反应具有一定CT影像特征。Objective To investigate CT features of similar Hexheimer＇s reaction during initial treatment of active pulmonary tuberculosis. Methods The similar Hexheimer＇ s reaction in 44 patients diagnosed by clinic and follow-up CT scans were retrospectively reviewed by three radiologists. Results During initial treatment of active pulmonary tuberculosis, development of radiographic progression were observed in 57 loci, including 28 pulmonary lesions increased at the site of their original lesion or new opacities elsewhere, ipsilateral or contralateral to the original lesion or both, 10 lesions related to the pleura （pleural effusion, pleural tuberculoma）, 15 lymphadenectasis, 3 thymus reactions, and 1 cardiac pericardium thickening, respectively. These reactions appeared from the 20 days to 3.5 months, then with continuation of the initial chemotherapy for 1.0- 3.0 months, the radiographic response was excellent with the areas of progression and the original lesions demonstrating resolution or improvement. Conclusion The CT appearances of similar Hexheimer＇ s reaction during initial treatment of active tuberculosis are specific to a certainty.

关 键 词：结核 肺 类赫反应 体层摄影术 X线计算机 

分 类 号：R978.3[医药卫生—药品] R743.35[医药卫生—药学]