探讨胞内分枝杆菌型NTM肺病的临床与MSCT表现  

Clinical and MSCT Features of Pulmonary M. Intracellulare Infection

作　　者：姚景江[1] 贺亚琼[2] 张亚林[1] 

机构地区：[1]长沙市中心医院放射科,410004 [2]湖南省人民医院放射科

出　　处：《临床放射学杂志》2017年第7期981-983,共3页Journal of Clinical Radiology

摘　　要：目的探讨胞内分枝杆菌非结核分枝杆菌(NTM)肺病的临床特点与CT征象。方法回顾性分析37例经临床确诊的胞内分枝杆菌型NTM肺病患者的CT资料与电子病历,并对其临床及影像学表现进行分析。结果37例患者最常见的临床症状为咳嗽咳痰,其次为咯血和活动后气促,约1/3患者原有继发型肺结核病史,1/3伴有慢性基础性肺病。最常见的CT表现为小叶中心结节即树芽征(97.3%),其次为支气管扩张(73.0%)、斑片状实变灶(54.1%)和纤维条索灶(43.2%),较少见的征象为厚壁空洞,仅见2个厚壁空洞病灶,且均位于右上肺。在合并支气管扩张患者中,右中叶和左舌叶出现支气管扩张的概率最高,分别达到56.8%和51.4%。纵隔和肺门淋巴结肿大和胸腔积液并不常见。结论胞内分枝杆菌型NTM肺病约1/3伴有慢性基础性肺病,主要CT表现为树芽征、支气管扩张、实变、结节和薄壁空洞,且支气管扩张好发于右中叶和左舌叶。Objective To investigate the clinical features and CT findings of pulmonary M. Intracellulare infection.Methods The CT data and electronic medical records of 37 patients with pulmonary M. Intracellulare infection were retrospectively analyzed. The clinical and CT findings were recorded. Results The most common clinical symptoms were cough and sputum,followed by hemoptysis and dyspnea. 1/3 of the patients had underlying chronic lung disease or previous pulmonary tuberculosis. The most common CT findings was centrilobular nodules（ 97. 3%）,followed by bronchiectasis（ 73. 0%）,patchy consolidation（ 54. 1%） and fibrous lesion（ 43. 2%）,the most rare sign was the thick wall cavity,only tow thick wall cavitary lesions were recorded,in the right upper lobe. In patients with bronchiectasis the right middle lobe（ 56. 8%） and left lingular lobe（ 51. 4%） were the most frequently involved lobes. Mediastinal and hilar lymph node enlargement and pleural effusion were not common. Conclusion 1/3 of the patients with pulmonary M. Intracellulare infection was associated with underlying chronic lung disease. The main CT findings were centrilobular nodules,bronchiectasis,consolidation,nodules and thin wall cavity. Bronchiectasis was most frequently found in the right middle lobe and left lingular lobe.

关 键 词：胞内分枝杆菌 非结核分枝杆菌 肺部疾病 体层摄影术 X线计算机 

分 类 号：R563[医药卫生—呼吸系统] R816.41[医药卫生—内科学]