中青年继发性肺结核空洞与空洞外肺结核病变的CT表现分析  

CT Manifestations of the Cavity of Secondary Pulmonary Tuberculosis and Lung Lesions Outside the Cavities in the Young and Middle Patients

作　　者：莫国友[1] 姚亮平[1] 陈勤[1] 

机构地区：[1]东莞市桥头医院放射科,广东东莞523520

出　　处：《实用放射学杂志》2010年第7期953-956,共4页Journal of Practical Radiology

基　　金：广东省医学科学技术研究基金资助项目（编号：A2009369）.

摘　　要：目的 分析中青年继发性肺结核空洞CT表现类型与空洞外肺内结核病变影像特点的关系.方法 有X线平片、CT平扫及高分辨扫描影像资料并经抗结核治疗动态复查的126例病例进行回顾性分析,空洞分为薄壁空洞、厚壁空洞或虫蚀空洞.结果 ①126例患者CT检出186个空洞,X线平片显示47例（37.3%）55个空洞（29.6%）.②胸部CT示薄壁空洞与厚壁空洞例数之比为1GA9552.5（36/90）.③空洞外肺内病变包括：小叶中心结节92例（73.0%）,树 芽征87例（69.0%）,磨玻璃密度62例（49.2%）, 小叶斑片实变52例（41.2%）,支气管异常48例（38.1%）,间质线状影24例（19.0%）,大叶实变13例（10.3%）,胸膜增厚、胸腔积液39例（30.9%）,淋巴结肿大14例（11.1%）,所有病例均为2种以上肺部病变并存.④厚壁空洞肺内病变在小叶中心结节、磨玻璃密度、树芽征、小叶斑片实变、大叶肺实变方面较薄壁空洞常见且治疗后易吸收.结论 中青年继发性肺结核空洞类型与壁外肺内结核的HRCT表现能反映继发型肺结核的病理过程,有助于确定肺结核的活动性,评价预后、治疗效果.Objective To analyze the CT signs of the secondary pulmonary tuberculous cavities and lung lesions outside the cavities in the young and middle patients. Methods 126 cases with tuberculous cavities diagnosed by serial radiographs,CT and HRCT were analyzed retrospectively. The cavities were divided into two types：thin wall and thich wall. Results { 1 ）65 cavities in 47 cases and 186 cavities in 126 cases were detected by X--ray and CT, respectively. （2）The rate of thin wall and thick wall cavities was 1 ： 2.5 （ 36/90 ）. （ 3 ） CT manifestations of lung lesion outside the cavities included ： centrilohular nodules in 92 cases（ 73.0 % ）, tree in bud appearance in 87 cases（ 69.0 % ） , ground-- grass sign in 62 cases （ 49.2 % ）, lobular consolidation in 52 cases （41.2 % ） , thickening of bronchial walt in 48 cases （38.1%） ,line shadows in 24 cases（ 19.0 %）,lobe consolidation in 13 cases（ 10.3 %） , pleural thickening or effusions in 39 cases（30.9 %） , hilar and mediastinat adenopathy in 14 cases（11.1%） and more than two abnormal findings co--exis- ted in all cases. （4）The centrilobular nodules, tree--in--bud appearance, consolidation, and ground--grass shadows were more seen in thick wall cavities than thin wall one. Lung lesions in most thick wall cavities had better therapeutic effect after treatment. Conclusion CT type of the pulmonary tuberculous cavities and the other lung lesion are valuable for diagnosis the active pulmonary tuberculosis, and also useful in evaluating prognosis.

关 键 词：肺 肺结核 空洞 体层摄影术 X线计算机 

分 类 号：R523[医药卫生—内科学] R814.42[医药卫生—临床医学]