肺间质改变为主的继发性肺结核的CT表现  

CT characteristics of secondary pulmonary tuberculosis mainly with pulmonary interstitial changes

作　　者：刘连荣[1] 张雪君[2] 程湘[1] 

机构地区：[1]天津市海河医院放射科,天津300350 [2]天津医科大学医学影像学院

出　　处：《实用放射学杂志》2014年第2期219-222,共4页Journal of Practical Radiology

摘　　要：目的 探讨以肺间质改变为主的继发性肺结核的CT表现.方法 收集20例CT图像上以间质性改变为主,经病理或临床证实的继发性肺结核病例的影像资料,包括普通CT及HRCT扫描,其影像表现以肺间质性改变为主.结果 20例以肺间质改变为主的继发性肺结核好发于两肺上叶,其中8例表现为广泛性肺间质改变,并出现散在斑片影,边界模糊;另12例沿支气管树呈节段性分布,边界较清晰.CT图像上以肺间质改变为主：表现为多发小叶内细网织影,小叶间隔增厚,结节影,树芽征,磨玻璃样密度影及支气管血管束异常,检出例数分别为20例（20/20）,20例（20/20）,20例（20/20）,20例（20/20）,9例（9/20）和10例（10/20）.经常规抗结核治疗后上述肺间质改变均有不同程度的吸收好转.结论 以间质性改变为主的肺结核是一种特殊类型的继发性肺结核,年轻患者中发病率较高,不同于以往的渗出、增殖性改变.间质性改变亦是结核病的一种表现形成,经抗结核治疗后随着结核性增殖灶的减少和吸收,间质性改变也会减轻,不需要再进行抗感染治疗.Objective To investigate the CT characteristics of secondary pulmonary tuberculosis with pulmonary interstitial changes.Methods To collect the imaging data of 20 patients who were diagnosed as tuberculosis by pathology or clinical.The imaging findings were predominantly pulmonary interstitial involved.The methods included CT and HRCT scanning.Results In 20 cases,interstitial abnormalities were found predominantly in bilateral upper lung,of which 8 cases showed extensive pulmonary interstitial changes,and blurred patchy shadow; another 12 cases were distributed with segmentation along the bronchial tree,boundaries were clear.CT identified interlobular thin reticulation in 20 cases（20/20） and micro-nodule in 20 cases（20/20）,Tree-in-bud sign in 20 cases（20/20）,ground-glass opacity in 9 cases（9/20）,and abnormal bronchovascular bundles in 10 cases（10/20）.The changes of pulmonary interstitial absorbed in different degree after regular anti-tuberculosis treatment.Conclusion It is a special kind of secondary tuberculosis which mainly manifested interstitial changes and are easy to occur in young patients.It is different from exudation,proliferative changes.Interstitial changes are also a manifestation of tuberculosis.With the tuberculosis proliferative foci reduction and absorption after anti-tuberculosis therapy,the interstitial changes would also be absorbed,don＇t need anti-inflammatory therapy.

关 键 词：肺结核 肺间质 计算机体层成像 

分 类 号：R521[医药卫生—内科学] R814.42[医药卫生—临床医学]