比较HIV阳性和HIV阴性患者粟粒型结核CT征象  

Comparing CT Signs of Miliary Tuberculosis in HIV-positive and HIV-negative Patients

作　　者：彭程[1] 王立非[1] 梁芳芳[2] 曹义[1] PENG Cheng;WANG Li-fei;LIANG Fang-fang(Department of Radiology Diseases,Shenzhen Third People＇s Hospital,Shenzhen 518020,Guangdong Province,China)

机构地区：[1]深圳市第三人民医院放射科,广东深圳518020 [2]深圳市儿童医院肾病免疫科,广东深圳518017

出　　处：《罕少疾病杂志》2018年第4期14-16,24,共4页Journal of Rare and Uncommon Diseases

基　　金：深圳市医疗卫生三名工程:项目编号:SZSM201612053;中山大学肿瘤防治中心张福君教授重症肝病影像诊断与微创介入治疗团队

摘　　要：目的探讨HIV阳性患者粟粒型肺结核的CT表现特征,认识到HIV阳性和阴性患者肺部CT征象的差异可能有助于建立早期诊断粟粒性结核患者的免疫状态。方法回顾性分析本院临床确诊的12例艾滋病伴粟粒型肺结核和40例单纯粟粒型肺结核的CT资料,观察肺粟粒结节的结节大小、分布、密度、磨玻璃影、结节边缘、肺内增殖/纤维化病灶、纵隔淋巴结肿大、胸腔积液、心包积液、肺外结核。结果 CT图像上,12例艾滋病伴粟粒型肺结核,结节大小一致9例,分布均匀5例,密度均匀3例,磨玻璃影,结节边缘,肺内增殖/纤维化病灶1例,纵隔淋巴结肿大6例,胸腔积液7例,心包积液5例,胸腔外累计6例。43例单纯粟粒型肺结核中,结节大小一致32例,分布均匀37例,密度均匀33例,密度均匀26例,磨玻璃影3例,结节边缘8例,肺内增殖/纤维化病灶12例,纵隔淋巴结肿大12例,胸腔积液8例,心包积液3例3。结论艾滋病伴粟粒型肺结核与单纯粟粒型肺结核在结节分布、大小和密度、结节边缘、纵隔淋巴结肿大、浆膜腔积液、肺外结核等方面螺旋CT表现特征明显不同,这些特征与它们的自身免疫功能活性有密切关系。Objective To investigate the CT features of miliary tuberculosis in HIV-positive patients, it is recognized that differences in CT signs of lung in HIV-positive and negative patients may help to establish an early diagnosis of the immune status of patients with miliary tuberculosis. Methods Helical CT features（distribution,size,density and Sharp margin of miliary nodule, and hydrops pericardil, Pleural effusion, Mediastinal lymphadenopathy,and attenuation of the lung,and extrapulmony tuberculosis） of 12 HIV patients complicated by military pulmonary tuberculosis and 40 patients with miliary tuberculosis metastatic nodules were retrospectively reviewed. ResultsThe uniformly distribution and density and size of the bilateral lung and Sharp margin miliary pulmonary nodules, hydrops pericardil, Pleural effusion, Mediastinal lymphadenopathy, and attenuation of the lung,and extrapulmony tuberculosis,were observed in 9 HIV infection of military pulmonary. Conclusion AIDS with millet grain size and the shape of pulmonary tuberculosis with Chan Chun Su tuberculosis on the distribution of the nodules, size and density, nodal brim, mediastinal lymph node enlargement, serous cavity effusion, extrapulmonary tuberculosis spiral CT clearly different performance characteristics, these characteristics have close relationship with their own immune function.

关 键 词：肺 艾滋病 粟粒型肺结核 体层摄影术 X线计算机 

分 类 号：R322.35[医药卫生—人体解剖和组织胚胎学] R512.91[医药卫生—基础医学]