肺间质病变继发性肺结核患者的高分辨率CT特征  

High-resolution CT characteristics of patients with interstitial lung disease complicated with secondary pulmonary tuberculosis

作　　者：戴粹新 戴文君 戴粹民 陈武 DAI Cuixin;DAI Wenjun;DAI Cuimin;CHEN Wu(Department of Imaging,Jingdezhen Fifth People's Hospital,Jiangxi Province,Jingdezhen 333000,China)

机构地区：[1]江西省景德镇市第五人民医院影像科,江西景德镇333000

出　　处：《中国当代医药》2022年第31期133-135,139,共4页China Modern Medicine

基　　金：江西省景德镇市社会发展科技计划项目(SF20133107)。

摘　　要：目的探讨肺间质病变继发性肺结核患者的高分辨率CT(HRCT)特征。方法选取2018年6月至2021年12月景德镇市第五人民医院收治的68例肺间质病变继发性肺结核患者作为研究对象,分析患者的HRCT检查影像学特征,包括病变部位、分布特点、伴随征象等。结果HRCT显示肺间质病变继发性肺结核患者病变部位多见于肺上叶,共累及155个肺段,其中左、右肺上叶尖后段病变占比较高,分别为33.55%(52/155)、30.97%(48/155);病变具体部位肺叶段中央及叶间胸膜占比较高,分别为48.39%(75/155)、36.13%(56/155);肺小叶内间质出现异常,其中细微结节及小叶内细网织线样阴影的检出率为100%;痰培养阳性者出现空洞征的占比高于痰培养阴性者,差异有统计学意义(P<0.05)。结论HRCT检查可清晰呈现肺间质病变继发性肺结核患者肺小叶内的细微病变,病灶好发部位、形态学特征可作为该病与其他间质性肺部疾病的鉴别依据,具备较高的诊断价值。Objective To investigate the high-resolution CT(HRCT)features of pulmonary interstitial disease secondary to pulmonary tuberculosis.Methods A total of 68 patients with pulmonary interstitial disease secondary pulmonary tuberculosis admitted to Jingdezhen Fifth People's Hospital from June 2018 to December 2021 were selected as the research objects.The imaging characteristics of HRCT examination of the patients were analyzed,including lesion location,distribution characteristics and accompanying signs.Results HRCT showed that the lesions in patients with secondary pulmonary tuberculosis mainly with interstitial changes were more common in the upper lobe of the lung,involving a total of 155 lung segments,and the lesions of the posterior segment of the left and right upper lobe of the lungs accounted for 33.55%(52/155)and 30.97%(48/155)respectively.The proportions of lesion specific parts of middle segment of lung and interlobar pleura were higher with 48.39%(75/155)and 36.13%(56/155)respectively.There were abnormalities in the interlobular interstitium,and the detection rates of fine nodules and intralobular fine reticulate shadows was 100%.The proportion of cavitation sign in patients with positive sputum culture was higher than that in patients with negative sputum culture,the difference was statistically significant(P<0.05).Conclusion HRCT examination can clearly show the subtle lesions in the pulmonary lobules of patients with secondary pulmonary tuberculosis mainly with interstitial changes.The focal location and morphological characteristics of the lesions can be used as the basis for distinguishing the disease from other pulmonary interstitial lesions,with high diagnostic value.

关 键 词：肺间质 继发性肺结核 高分辨率CT 影像学特征 

分 类 号：R521[医药卫生—内科学]