多层螺旋CT在不典型性肺结核中的应用价值及影像特征分析  

Application Value and Imaging Features of Multi-slice Spiral CT in Atypical Tuberculosis

作　　者：李倩倩[1] 姜静[1] 范海芸 LI Qian-qian;JIANG Jing;FAN Hai-yun(Department of Ultrasound,Qingdao Municipal Hospital,Qingdao 266000,Shandong Province,China)

机构地区：[1]山东省青岛市市立医院超声科,山东青岛266000

出　　处：《中国CT和MRI杂志》2020年第6期62-64,共3页Chinese Journal of CT and MRI

摘　　要：目的探究多层螺旋电子计算机断层扫描(MSCT)在不典型性肺结核中的应用价值并分析其影像特征。方法回顾性分析我院78例不典型性肺结核患者临床资料。分析78例患者临床症状、临床体征及MSCT影像特征情况。结果 78例不典型性肺结核患者临床症状以咳嗽咳痰为主,其次为发热、乏力消瘦、胸闷或呼吸困难、咯血、胸痛、胸水,且有19例患者(24.36%)无临床症状。78例不典型性肺结核患者临床体征以呼吸音减弱为主,其次为肺部湿罗音,且有47例患者(60.26%)无肺部体征。78例不典型性肺结核患者MSCT影像特征主要有肺炎实变型(38例,48.72%),弥漫间质型(16例,20.51%),单发结节型(13例,16.67%),多发结节型(11例,14.10%);其中肺炎实变型MSCT表现主要为支气管充气征、边界模糊、树芽征、空洞、磨玻璃影等,弥漫间质型MSCT表现主要为树芽征、结节灶、间质性改变、磨玻璃影、空洞,单发结节型MSCT表现主要为结节灶、淋巴结肿大、空洞、条索灶、钙化灶等,多发结节型MSCT表现主要为结节灶、空洞、条索灶、树芽征、淋巴结肿大等。结论不典型性肺结核的MSCT影像学表现具有多样性,临床应综合实验室检查等多种特征完成诊断。Objective To explore the application value of multi-slice spiral computed tomography(MSCT) in atypical tuberculosis and to analyze its imaging features. Methods The clinical data of 78 patients with atypical tuberculosis were retrospectively analyzed. The clinical symptoms, clinical signs and MSCT imaging features were analyzed among 78 patients. Results The clinical symptoms of 78 patients with atypical tuberculosis were cough and expectoration, followed by fever, fatigue weakness and weight loss, chest tightness or dyspnea, hemoptysis, chest pain and pleural effusion, and 19 patients(24.36%) were without clinical symptoms. The clinical signs of 78 patients with atypical tuberculosis were mainly diminished respiration, followed by lung wet rales, and 47 patients(60.26%) were without lung signs. The MSCT imaging features of 78 patients with atypical tuberculosis were mainly pneumonia consolidation type(38 cases, 48.72%), diffuse interstitial type(16 cases, 20.51%), solitary nodule type(13 cases, 16.67%) and multiple nodule type(11 cases, 14.10%). The MSCT findings of pneumonia consolidation type showed mainly air bronchogram, blur boundary, tree-in-bud sign, cavitation and ground glass opacity, and the MSCT findings of diffuse interstitial type showed mainly treein-bud sign, focal nodules, interstitial changes, ground glass opacity and cavitation, and MSCT findings of solitary nodule type showed mainly focal nodules, lymphadenopathy, cavitation, strip lesions and calcifications, and MSCT findings of multiple nodule showed mainly focal nodules, cavitation, strip lesions, tree-in-bud sign and lymphadenopathy. Conclusion MSCT imaging findings of atypical tuberculosis are diverse, and the clinical diagnosis should be completed by various features of laboratory tests.

关 键 词：不典型性肺结核 MSCT 影像特征 

分 类 号：R445.3[医药卫生—影像医学与核医学] R521[医药卫生—诊断学]