肺部感染性疾病CT树芽征病因病理及其诊断价值.docVIP

肺部感染性疾病CT树芽征病因病理及其诊断价值 　 作者：赵欣，李鹏，龙健，曾红辉 【关键词】 树芽征 　　［关键词］ 树芽征；肺部感染性疾病；X线计算机；体层摄影术 　　［摘 要］ 目的：复习并探讨CT树芽征的病因病理和影像特点，评价其诊断价值。方法：对99例各类肺部感染性疾病行CT检查，对各类疾病树芽征的形态、部位及共存征象进行统计分析。结果：痰涂阳性肺结核、空洞性肺结核、慢性支气管炎合并感染及支气管扩张合并感染的树芽征出现率分别达到了90.0%、94.1%、88.9%及78.3%。边缘较锐利的树芽征出现在肺结核中。肺结核树芽征所在叶段支气管可表现无异常，慢性支气管炎合并感染及支气管扩张合并感染的树芽征所在叶段支气管均有异常表现。结论：肺结核树芽征有不同于其他肺部感染性疾病的形态及分布特点。 　　　　Pathogenesis and Value of Treeinbud at Diagnosis of Pulmonary Infections 　　ZHAO Xin,LI Peng,Long Jian,et al 　　Abstract:Objective To review the pathogenesis and analyze the value of the photographic character of treeinbud at diagnosis of pulmonary infections.Methods To check 99 pulmonary infections patients with CT and statistic the formation and location of treeinbud and the other signs at various pulmonary infections separately.Results The occurrence rates of treeinbud at smear positive and cavity pulmonary tuberculosis were 90.0% and 94.1% respectively.The occurrence frequency of treeinbud in chronic bronchitis and bronchiectasis with secondary infection were 88.9% and 78.3%. The margin of teeinbud being clear occurred only in pulmonary tuberculosis.Some of the lober,segmental or subsegmental level bronchi with treeinbud in the same lobe were normal in pulmonary tuberculosis.While at least one level of the bronchi with treeinbud in the same lobe were abnormal in chronic bronchitis or bronchiectasis with secondary infection.Conclusion The treeinbud sign in pulmonary tuberculosis has some characters different from the other pulmonary infections in the formation and location. 　　Key words:Treeinbud pulmonary； Infections; Xray computed； Tomography 随着CT的广泛运用，各类肺部感染性疾病的细节征象得以显示，其中树芽征（treeinbud）出现率较高，不同疾病其CT表现也不尽相同。本文对我院肺部CT影像中的树芽征表现及其病因病理进行比较分析，探讨其诊断价值。 　　1 资料和方法 　　1.1 一般资料 　　回顾性分析2002年至2005年我院经临床及病理证实并有同期CT影像资料的各类肺部感染性疾病共99例。男65例，女34例；年龄21岁~76岁，平均年龄51岁。其中继发性肺结核43例（痰涂或痰培养阳性20例，痰涂阴性23例；空洞性肺结核17例，无空洞性肺结核26例）；慢性支气管炎并感染27例；支气管扩张并感染23例；支气管肺炎6例。 　　1.2 方法 　　1.2.1 树芽征的判定标准 　　指病变累及细支气管，炎性渗出物及分泌物堵塞细支气管管腔，CT表现为直径2 mm~4 mm的小叶中心结节