艾滋病合并肺结核的影像学检查和特征  

Imaging examinations and characteristics of pulmonary tuberculosis with AIDS

作　　者：韦菊临[1] 梁桂录[1] 刘军 李鼎胜 韦仁柳 WEI Julin;LIANG Guilu;LIU Jun;LI Dingsheng;WEI Renliu(Department of Radiology,the People＇s Hospital of Liucheng,Liuzhou 545200,China)

机构地区：[1]柳城县人民医院放射科,广西柳州545200

出　　处：《实用放射学杂志》2018年第9期1351-1353,共3页Journal of Practical Radiology

基　　金：柳城县科学研究与技术开发计划项目（20150101）。

摘　　要：目的 探究艾滋病（AIDS）合并肺结核的影像学特征，旨在提高临床医师对AIDS合并肺结核的认识。方法 收集本院收治的AIDS合并肺结核患者40例作为A组，选取同时期单纯肺结核患者40例作为B组，行胸部CT扫描、摄胸部X线正侧位片，分析2组患者影像学资料。结果 A组、B组患者胸腔积液发生情况无统计学差异（P〉0.05）。A组患者X线多表现为粟粒结节影、磨玻璃影，2例可见厚壁空洞，内壁欠规则；B组患者X线表现为斑片影或实变影，1个或多个空洞。A组患者病变多累及2段及以上，病变常位于下肺叶，易伴有胸内淋巴结肿大和肺外结核；B组患者病变常位于上肺叶或肺尖，常表现为增殖性病灶。结论 AIDS合并肺结核和单纯肺结核影像学特征差异明显，AIDS合并肺结核影像学表现为多发生在下肺叶、多累及≥2个肺段、磨玻璃影、粟粒结节影、胸内淋巴结肿大、肺外结核。Objective To explore the imaging characteristics of pulmonary tuberculosis with AIDS, to improve clinicians＇ understanding of this pathological entity.Methods Forty patients diagnosed as AIDS with pulmonary tuberculosis were collected as group A in our hospital,and other 40 patients diagnosed as pulmonary tuberculosis were collected as group B at the same time. Chest radiography and CT were performed and the imaging data of the two groups were analyzed and compared. Results There was no significant difference in the occurrence of pleural effusion between group A and group B （P〉0.05）. In group A, X-ray showed miliary nodules and ground-glass opacity in most patients, and thick wall cavity with irregular inner wall in 2 patients. In group B, X-ray showed patchy shadow or consolidation, with single or multiple cavities.The lesions were usually located in the lower lobes and involved more than 2 segments, often accompanying intrathoracic lymph node enlargement and extrapulmonary tuberculosis in group A.The lesions often occurred in the upper lobes or apical segments,manifesting as proliferative loci in group B.Conclusion The difference of imaging manifestations between pulmonary tuberculosis with AIDS and pulmonary tuberculosis was significant. The pulmonary tuberculosis with AIDS presents as miliary nodules and ground-glass opacity,usually is located in the lower lobes and involved more than 2 segments, often accompanying intrathoracic lymph node enlargement and extrapulmonary tuberculosis.

关 键 词：艾滋病 肺结核 计算机体层成像 放射摄影术 

分 类 号：R512.91[医药卫生—内科学] R814.42[医药卫生—临床医学]