肺结核不典型的X线_CT表现及误诊分析_附30例报告_.pdfVIP

24 2003 1 18 1 Radiol Practice, Jan 2003, Vol 18, No. 1 ## X CT ( 30 ) 肖观东 李本美 刘亚萍 王广平 刘爱明 李发洲 程襄忠 = : 提高对肺结核不典型表现的X CT 表现的认识, 避免误诊: 30 例肺结核不典型表现的患者 中, 男14 例, 女16 例, 年龄 18~ 55 岁, 平均36 岁摄正位胸片 21 例侧位8 例CT 20 例由4 名影像科医师, 每两人 一 组, 采取双盲法读片, 总结X CT 表现及分析误诊原因: 30 例不典型肺结核中支气管内膜结核 7 例, 节段实变型 及肺叶型各3例, 结节或肿块型5 例, 粟粒结节状及多发结核瘤各2 例, 空洞型4 例, 下叶结核4 例共误诊 13例, 其中误 为肺癌6 例, 误为炎症5 例, 1例误为肺泡癌或转移癌, 1 例误为转移癌: 肺结核不典型的X , CT 表现各有特点 部位形态不典型, 影像检查不全面, 过分依赖某些征象的诊断价值, 忽视临床等为主要误诊原因 = 结核, 肺; X 照片; 体层摄影术, X 计算机; 误诊 = R814, R814. 42, R521 = A = 1000-0313( 2003) 01-0024-04 Analysis of atypical X-ray and CTfindings andmisdiagnosis of pulmonary tuberculosis XIAO Guandon , LI Benmei, LIU Yapin , et al. Department of Ridiolo y , Jin zhou Chest Hospital, Hubei 434 100 = Abstract Objective:To improve knowled e of atypical X-ray and CT findin s of pulmonany tuberculosis ( APT) and to avoid misdia nosis. Methods:There were 30 cases of APT a ed 18~ 56 years ( mean 36 years) , and were 14 males and 16 females. 21 of them took the frontal chest radio raphy, 8 did additional lateral chest radio raphy and 20 did additional CT scannin .Their ima es were analyzed in a blinded manner by 4 radiolo ists who were divided into two roups by random. Results:In the 30 cases of APT , 7 were endobronchial tuberculosis, 3 se mental and 3 lobar consolidation type, 5 nodule or mass type, 2 miliary tuberculosis and 2 multiple tuberculoma, 4 tuber- culous cavity, and 4 tuberculosis in lower lobe. 13 cases were misdia nosed as pulmonany carcinoma( n= 6) , inflammation( n= 5) , alveoli carcinoma or metastasis( n= 2) . Conclusion:All kinds of APT display their own radiolo ical and CT features. The main reasons of misdia- nosis include the atypical location and manifestation of TB, incomprehensiv