【摘要】 目的 :提高对肺结核不典型表现的X线、CT表现的认识 ,避免误诊。方法 :3 0例肺结核不典型表现的患者中 ,男 14例 ,女 16例 ,年龄 18～ 5 5岁 ,平均 3 6岁。摄正位胸片 2 1例、侧位 8例、CT 2 0例。由 4名影像科医师 ,每两人一组 ,采取双盲法读片 ,总结X线、CT表现及分析误诊原因。结果 :3 0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。结论 :肺结核不典型的X线 ,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更多还原

【Abstract】 Objective:To improve knowledge of atypical X ray and CT findings of pulmonany tuberculosis (APT) and to avoid misdiagnosis.Methods:There were 30 cases of APT aged 18～56 years (mean 36 years),and were 14 males and 16 females.21 of them took the frontal chest radiography,8 did additional lateral chest radiography and 20 did additional CT scanning.Their images were analyzed in a blinded manner by 4 radiologists who were divided into two groups by random.Results:In the 30 cases of APT,7 were endobronchial tuberculosis,3 segmental and 3 lobar consolidation type,5 nodule or mass type,2 miliary tuberculosis and 2 multiple tuberculoma,4 tuberculous cavity,and 4 tuberculosis in lower lobe.13 cases were misdiagnosed as pulmonany carcinoma(n=6),inflammation(n=5),alveoli carcinoma or metastasis(n=2).Conclusion:All kinds of APT display their own radiological and CT features.The main reasons of misdiagnosis include the atypical location and manifestation of TB,incomprehensive imaging exams,excessive dependence on certain radiological signs and ignorance of clinical manifestation.更多还原