肺结核的CT诊断价值  

Diagnostic value of CT in pulmonary tuberculosis

作　　者：周怀琪[1] 孙鹏飞[1] 张皓[1] 张晓莹[1] 房斌[1] 

机构地区：[1]兰州医学院第一附属医院放射科,甘肃730000

出　　处：《放射学实践》2002年第4期338-340,共3页Radiologic Practice

摘　　要：目的:探讨CT对肺结核的诊断价值与鉴别诊断。方法:回顾分析经病理和临床证实的86例肺结核病CT表现,并与X线平片作对照分析。结果:①好发部位为两肺上叶尖后段、下叶背段（57例）;②多呈不规则斑片状影,边界不清,密度不均;③43例可见病灶内钙化,呈散在斑片状或斑点状;④27例存在薄壁或厚壁空洞,其中多发小空洞8例;⑤病灶周围有支气管播散灶者25例;⑥纵隔淋巴结增大14例,纵隔淋巴结钙化35例;⑦胸腔积液19例,胸膜增厚、粘连37例,胸膜钙化4例。结论:CT检查能较X线检查进一步肯定或补充有临床价值的征象,包括空洞、支气管扩张、肺大泡、纵隔淋巴结肿大或钙化和胸膜肥厚下的肺内结核;经X2检验,二者间有显著差异（P<0.05）。CT显著提高活动性肺结核的诊断正确性（61.9％）,并提出肺结核合并肺癌的CT诊断依据。Objective:To study the CT appearances of pulmonary tuberculosis and to assess their value for diagnosis and differential diagnosis. Methods: CT findings of 89 cases of pulmonary tuberculosis proved pathologically or clinically, were retrospectively analyzed. CT findings were compared with that of X-ray film. Results: (1)Predominant location of pulmonary TB:the apicoposterior segment of both upper lobes and the dorsal segment of inferior lobes(57 cases) ;(2)Form of the lesion; heterogeneous, irregular and illegible opacities in most cases;(3)Calcification inside the lesion; mottling or patch-y in 43 cases;(4)Thin or thick wall cavities in 27 cases, including multiple small cavities in 8 cases;(5)Bronchogenic spread in 25 cases ;(6)Mediastinal iymphadenopathy in 14 cases and mediastinal nodal calcification in 35 cases; (7) Hydrothorax in 19 cases, pleural thickening and adhesion in 37 cases,pleural calcification in 4 cases. Conclusion:CT is able to give further suggestion and provide more information than X-ray film. Moreover, it can improve the diagnostic accuracy of active pulmonary tuberculosis,and warrant diagnosis of pulmonary TB accompanying lung cancer.

关 键 词：CT诊断 肺结核 诊断价值 鉴别诊断 

分 类 号：R816.41[医药卫生—放射医学]