糖尿病合并肺结核的CT诊断  

CT Diagnosis of Pulmonary Tuberculosis in the Diabetes

作　　者：胡荣剑[1] 王妍焱[1] 潘纪戍[1] 

机构地区：[1]北京医院放射科,北京100730

出　　处：《中国医学影像技术》2000年第9期766-768,共3页Chinese Journal of Medical Imaging Technology

摘　　要：目的　讨论糖尿病合并肺结核的CT表现特点。方法　本文 2 8例全部作了常规胸部CT扫描以及局部病灶区加扫 1mm薄层 ,9例作了动态增强扫描 ,延迟时间分别在注射造影剂 80～ 10 0mL后的 30s ,2min和 5min。结果　本组 2 8例共有 5 1个肺段发现病变 ,其中肺结核常见部位占 70 6 % ,少见部位 2 9 4% ,17例 (6 0 7% )呈多个肺段病变 ,11例 (39 3% )表现为单个肺叶或肺段病变 ,其中 8例发生在少见部位。CT征象多表现为活动性病变 ,其中大片状实变影 (17 4% )、空洞影包括 1例多发小空洞 (13 1% )、磨玻璃征 (10 9% )和树芽状支气管播散病灶(17 4% ) ,但结节和肿块影 (30 4% )也不少见 ,并且其中 7例病灶呈边缘强化。本组CT正确诊断 2 3例 (82 1% ) ,误诊 5例 (17 9% )。结论　在少见部位的较高发病率和实变区内多发小空洞是糖尿病并发肺结核较为特征性的CT表现 ,具有一定的诊断价值。Objective To discuss CT appearance of pulmonary tuberculosis in diabetic patients. Methods We reviewed conventional CT and 1 mm\|thick HRCT scans of the chest in 28 diabetic patients with tuberculosis,including dynamic enhancement scans at delay time of 30 seconds and 2 minutes and 5minutes after intravenous administration 80～100mL of contrast material in 9 patients. Results CT imaging showed tuberculosis in 51 lung segments,including 70 6% at unusual localization and 29 4% at unusual localization and 17(60 7%) patients for mutible lobes or segments diseases and 11 (39 3%) patients for the single lobes or segments diseases,8 of which at unusual localization.CT findings of active tuberculosis appears as consolidation (17 4%),single cavity and small mutible cavities (13 1%),ground\|glass opacity(10 9%),tree\|in\|bud sign(17 4%) in this study,but nodosity and mass (30 4%) were not rare,7 cases of which as border enhancement.23(82 1%) patients were diagnosed correctly and other 5 (17 9%) patients were misdiagnosed. Conclusion High prevalence of unusual localization and small mutible cavities were characteristic CT findings of pulmonary tuberculosis in diabetic patients and had certain diagnostic value. [

关 键 词：糖尿病 肺结核 CT 诊断 

分 类 号：R587.104[医药卫生—内分泌] R521.04[医药卫生—内科学]