【摘要】 目的通过对102例不典型肺结核患者的胸部CT影像学特征及临床资料的回顾性分析,提高对不典型肺结核诊断的准确率。方法回顾性分析2012年1月至2013年6月102例不典型结核患者的胸部CT影像表现、临床症状及诊断方法。结果 102例患者中表现为肺炎实变型48例(47.1%)、孤立结节或肿块型17例(16.7%)、多发结节型16例(15.7%)、间质改变型21例(20.6%);经痰涂片抗酸染色阳性而诊断79例(77.5%);经支气管镜获得组织病理检查诊断10例(9.8%);经CT引导下肺穿刺活检诊断13例(12.7%);经手术取得组织病理诊断14例(13.7%)。结论不典型肺结核的影像表现多样,需综合各种检查结果,同时结合临床特征及实验室检查等做出诊断。更多还原

【Abstract】 Objective To retrospectively analyze the clinical manifestations and CT characteristics of atypical pulmonary tuberculosis in 102 patients so as to improve its diagnostic accuracy. Methods During the period from Jan. 2012 to June 2013,a total of 102 patients with atypical pulmonary tuberculosis were encountered at authors’ hospital. The clinical data and CT imaging features were retrospectively analyzed. Results Of the 102 patients with atypical pulmonary tuberculosis,pneumonia consolidation type was seen in 48( 47. 1%),solitary nodule or mass type in 17( 16. 7%),multiple nodules type in 16( 15. 7%) and interstitial change type in 21( 20. 6%). In 79 patients( 77. 5%) the diagnosis was proved by positive acid-fast stain with sputum smear. Histopathologic examination through bronchoscopy biopsy confirmed the diagnosis in 10 patients( 9. 8%). CT-guided lung biopsy proved the diagnosis in 13 patients( 12. 7%). Histopathologic examination after surgery confirmed the diagnosis in 14 patients( 13. 7%). Conclusion Atypical pulmonary tuberculosis has various imaging manifestations. Therefore,combination use of different examination means and comprehensive consideration of clinical manifestations and laboratory results are of great importance in making a correct diagnosis.更多还原