肺间质改变为主的肺结核CT诊断.docVIP

肺间质改变为主的肺结核CT诊断 　　【摘要】 目的：探讨以肺间质改变为主的继发性肺结核的CT表现特点。方法：收集CT扫描图像上以肺间质改变为主，且经过临床或病理证实的继发性肺结核患者20例，男15例，女5例，年龄17～80岁，平均43.6岁。痰涂片检查阳性6例，另14例经临床抗结核治疗（3～12个月）及多次随访证实。所有患者均在抗结核治疗前后行多次CT检查。结果：该类型的肺结核好发于两肺上叶，多为节段性分布，呈小片状或大片融合状，多数肺间质病变与正常肺组织界限清楚。CT上肺间质改变主要表现为小叶内细状影、微结节、树芽征、小叶间隔增厚和细支气管壁增厚等，经抗结核治疗后肺间质性改变均有不同程度吸收。结论：以间质改变为主的肺结核是一种特殊类型的继发性肺结核，CT检查能够清晰客观显示该类型肺结核间质改变的特点，有助于该病的提示性诊断，并可以观察和评价治疗的预后。 　　【关键词】 肺结核； 肺间质； 计算机体层成像 　　中图分类号 R445 文献标识码 B 文章编号 1674-6805（2016）10-0041-03 　　【Abstract】 Objective：To investigate the CT features of secondary pulmonary tuberculosis with pulmonary interstitial change.Method：20 patients with secondary pulmonary tuberculosis confirmed by clinical or pathology，and their CT scan images were mainly pulmonary interstitial change，male 15 cases，female 5 cases，age 17-80 years old，average 43.6 years old.6 cases were confirmed as positive sputum smear examination，and the other 14 cases were confirmed by clinical anti tuberculosis treatment （3 to 12 months）and many times of follow-up.All patients underwent multiple CT examination before and after anti tuberculosis treatment.Result：This type of pulmonary tuberculosis was well distributed in the upper lobe of the lung in two，which was a segmental distribution，with a small patchy or large fusion，and the boundaries between the majority of pulmonary interstitial lesions and normal lung tissue were clear.Pulmonary interstitial changes in CT mainly showed in the small leaf fine shadow，micro nodule，tree bud sign，septal thickening and thin bronchial wall thickening，etc，after anti tuberculosis treatment of pulmonary interstitial changes had different degrees of absorption.Conclusion：Pulmonary tuberculosis with interstitial change，which is a special type of secondary pulmonary tuberculosis，CT can clearly and objectively shows the changes of pulmonary tuberculosis in the interstitial characteristics，contribute to the prompt diagnosis of the disease， and can observe and evaluate the therapeutic prognosis. 　　【Key words】