HIV/AIDS合并肺结核的CT表现  

CT Findings of Pulmonary Tuberculosis in Patients with HIV/AIDS

作　　者：杨冰[1,2] 孙希文[3] 江森[3] 

机构地区：[1]同济大学医学院 [2]上海市第八人民医院放射科 [3]同济大学附属上海市肺科医院放射科

出　　处：《中国医学计算机成像杂志》2013年第3期209-212,共4页Chinese Computed Medical Imaging

摘　　要：目的:分析HIV/AIDS合并肺结核患者的CT表现,以提高诊断。方法:回顾性分析17例HIV/AIDS合并肺结核患者的临床资料和胸部CT表现。结果:17例HIV/AIDS合并肺结核患者,男性11例,女性6例,年龄24～57岁,临床表现均有咳嗽、咳痰、低热等呼吸道症状。CT表现肺内病灶呈多样性,其中结节影6例,斑片、片块样实变影4例,空洞3例,树芽征8例,磨玻璃影4例。全部病例肺内病变可分布于各个肺叶,无显著好发部位,13例为肺内多种病变共存。肺门、纵隔淋巴结肿大9例,增强后出现环状强化。胸腔积液4例,其中合并心包积液1例。结论:HIV/AIDS合并肺结核的CT征象表现多样,但更多见淋巴结肿大、支气管播散、胸腔积液,具有一定特征性。Purpose： To study the CT findings of pulmonary tuberculosis in patients with HIV/AIDS and to improve the diagnostic accuracy of it. Methods： The chest CT images and clinical data of 17 HIV/AIDS patients with pulmonary tuberculosis were retrospectively studied. Results： These seventeen patients （6 women and 11 men; age ranged from 24 to 57 years） had respiratory symptoms as cough and expectoration were diagnosed as HIV/AIDS with pulmonary tuberculosis. The CT findings of lung lesions included nodules in 6 cases, consolidation in 4, cavity in 3, tree-in-bud signs in 8 and ground glass opacity in 4. All lung lesions were located in different lobes, there was no significant predilection sites. Thirteen cases were with coexisting multiple intrapulmonary lesions. Nine cases were found with enlarged hilum and mediastinal lymph nodes with ring-like enhancement. Other findings included pleural effusion in 4 cases and pericardial effusion in 1. Conclusions： CT scan plays an important role in the diagnosis of HIV/AIDS patients with pulmonary tuberculosis. Enlarged intrathoracic lymph nodes, bronchus dissemination and pleural effusion are most frequently occurred features.

关 键 词：结核 肺 人类免疫缺陷病毒 获得性免疫缺陷综合征 体层摄影术 X线计算机 

分 类 号：R512.91[医药卫生—内科学] R521[医药卫生—临床医学]