非结核分支杆菌肺病10例影像学特点及分析.docVIP

非结核分支杆菌肺病10例影像学特点及分析 　　[摘要] 目的 提高临床医师对非结核分枝杆菌肺病的CT影像学表现的认识，减少漏诊和误诊。方法 回顾性研究2009年9月～2013年9月经确诊的10例非结核分枝杆菌肺病的CT影像学表现，分析病变形态和累及范围。结果10例非结核分枝杆菌肺病的病灶累及右肺的5例（50%），累及左肺的3例（30%），双肺累及的2例（20%），其中病灶分布于右上肺尖的5例（50%）；肺内出现空洞8例（80%），其中5例为发生于2个肺叶以上的多发空洞，空洞周围浸润的3例；肺内出现支气管扩张7例（70%）；支气管播散少见1例（10%）。 结论 临床上当患者接受正规抗结核治疗无效而反复排菌，影像学表现为结节影、小斑片影、空洞、实变和支气管扩张等多种病变形态同时存在，特别是出现近胸膜下薄壁空洞时，需考虑NTM肺病，积极进行痰培养及菌种鉴定，减少漏诊和误诊。 　　[关键词] 非结核分枝杆菌；非结核分枝杆菌肺病；CT研究 　　[中图分类号] R563.1 [文献标识码] B [文章编号] 2095-0616（2013）22-205-03 　　Imaging features and analysis on 10 cases with nontuberculous mycobacteria pulmonary disease 　　DONG Shuangxia 　　Department of Respiration Medicine，Wenzhou Central Hospital，Wenzhou 325000，China 　　[Abstract] Objective To improve the acknowledge of clinicians on CT imaging findings of nontuberculous mycobacteria pulmonary disease， and reduce the missed diagnosis and misdiagnosis. Methods The CT imaging findings of 10 cases with nontuberculous mycobacteria pulmonary disease confirmed from September 2009 to September 2013 were retrospectively studied， and the lesions form and involved area were analyzed. Results In 10 cases with nontuberculous mycobacteria pulmonary disease，there were 5 cases（50%） with lesions involving the right lung，3 cases（30%） with lesions involving the left lung， and 2 cases（20%） with lesions involving the both lungs，of which 5 cases（50%） with lesions locating in the apex of right upper lung；8 cases（80%） occurred pulmonary cavity，of which 5 cases occurred multiple cavities that located in the more than 2 pulmonary lobes， 3 cases occurred pericavity infiltration；7 cases（70%） occurred pulmonary bronchiectasis； 1 case（10%） occurred scarce bronchogenic spread. Conclusion When the patients have invalid effect after receiving formal anti-TB therapy and occur repeated discharge of bacteria in clinical，the imaging findings show that many lesions form exist during the same period， including nodule shadows，small patchy shadows， cavities， consolidation and bronchiectasis，especially when