EBUS-TBNA明确诊断纵隔结核的CT影像学表现  

CT imaging of mediastinal lymph node tuberculosis diagnosed by endobrochial ultrasound-guided transbronchial needle aspiration

作　　者：蒋延文[1] 田庆[1] 马迎民[2] 杨震[1] 安杨[1] 王慧霜[1] 陈良安[1] 

机构地区：[1]解放军总医院呼吸内科,北京100853 [2]北京世纪坛医院呼吸内科,北京100038

出　　处：《军医进修学院学报》2012年第6期610-612,641,共4页Academic Journal of Pla Postgraduate Medical School

摘　　要：目的研究增强CT联合超声内镜引导下经支气管针吸活检(EBUS-TBNA)明确诊断的纵隔结核病例的临床及影像学特点,提高确诊率。方法对10例影像学表现以肺门、纵隔病变为主,临床疑诊为结核病的患者,行EBUS-TBNA检查,分析其临床特点及影像学特点。结果 10例经增强CT联合EBUS-TBNA以及试验性抗结核治疗,9例明确纵隔结核诊断,1例诊断为结节病。患者年龄17-71岁,平均(39±16.82)岁。发热、咳嗽为常见症状,咳痰症状少见。纵隔结核好发部位为4R区、7区及2R区淋巴结,增强CT常表现为不均匀强化、环形强化。结论纵隔结核临床及影像学表现有其特点,增强CT结合EBUS-TBNA有助于诊断。Objective To improve the understanding and diagnosis of mediastinal lymph node tuberculosis diagnosed by combined contrast-enhanced CT and endobrochial ultrasound-guided transbronchial needle aspiration（EBUS-TBNA） by analyzing its clinical and imaging features.Methods The clinical and imaging features of 10 patients with mediastinal lymph node tuberculosis manifested as hilar or mediastinal lesions diagnosed by EBUS-TBNA were analyzed.Results Of the 10 patients,9 were diagnosed as mediastinal tuberculosis and 1 as sarcoidosis after anti-tuberculosis treatment.The age of these patients was 17-71 years（mean 39±16.82 years）.Their common symptoms were fever and cough with rare expectoration.The predilection sites of mediastinal lymph node tuberculosis were located at 4,7 and 2R.Contrast-enhanced CT showed inhomogeneous and ring enhancement.Conclusion Mediastinal lymph node tuberculosis is characterized by its clinical and imaging manifestations.Combined contrast-enhanced CT and EBUS-TBNA contributes to its diagnosis.

关 键 词：支气管内超声引导针吸活检 纵隔 淋巴结 结核 CT 

分 类 号：R522[医药卫生—内科学]