【摘要】 目的:探讨非结核分枝杆菌(NTM)肺病的多层螺旋CT表现。方法:回顾性分析经实验室检查确诊的60例NTM肺病的CT表现。结果:NTM肺病的主要CT表现分为三型:(1)支气管扩张合并细支气管炎型(35例,35/60,占58.3%),支气管扩张均为柱状,同一肺叶均可见细支气管炎(即小结节和树芽征)。支气管扩张最常见于右肺中叶及左舌叶,均为24例(24/35),小结节灶最常见于左肺下叶(33例,33/35),树芽征最常见于右肺上叶(22例,22/35)。8例(8/35)患者合并空洞。(2)结核相似型(23例,23/60,占38.3%),主要CT表现为斑片状、片状、斑点状、结节状及索条状影,多种形态混合存在,伴空洞者16例(16/23),空洞数共44个,多发空洞10例(10/16),最常见于左肺上叶(10个)。伴支气管扩张者8例(8/23),均为柱状支气管扩张。树芽征4例(4/23)。肺不张4例(4/23),其内均可见柱状支气管扩张,胸膜增厚2例(2/23),单侧胸腔积液2例(2/23)。(3)混合型:1例右肺中叶大片状实变影,右肺下叶巨大肺大泡并感染;1例双肺多发大小不等小结节状影,边缘清楚,右肺上叶不张伴柱状支气管扩张及不规则空洞。结论:NTM肺病以柱状支气管扩张和细支气管炎表现为主要征象,其次类似于继发性肺结核表现,少数患者表现为其它征象,如大片状实变、多发结节灶。MSCT对该病的诊断具有重要价值。更多还原

【Abstract】 Objective:To analyze and summarize multi-slice CT(MSCT)findings of nontuberculous mycobacteria(NTM)pulmonary disease.Methods:60 cases of NTM pulmonary disease confirmed by laboratory tests were reviewed.Results:The major CT manifestations of NTM pulmonary disease were divided into three types:(1)Bronchiectasis with bronchiolitis:(35 cases,58.3%).All of bronchiectasis were cylindric type.Bronchiolitis(small nodules and "tree-in-bud" sign)was seen in the same lung lobe.Bronchiectasis was most common in the middle lobe of the right lung and left lingula(24 cases,68.6%).Small nodules were most common in left inferior lobe(33 cases,94.3%). " Tree-in-bud" signs were most distributed in the right upper lobe(22 cases,62.9%).8 cases had cavities.(2)Tuberculosis similar type(23 cases,38.8%).The chief CT features were mixed patchy,spotty,nodular and streaky shadows,cavity was present in 16 cases(16/23).The number of cavity was 44,10 cases(62.5%)showed multiple cavities,which were most distributed in left upper lobe(22.7%).8 cases(34.8%)accompanied with bronchiectasis,all of bronchiectasis were cylindric type,4 cases(17.4%)had "tree-in-bud" sign.2 cases had pleural thickening,and 2 cases had unilateral pleural effusion.(3)Mixed type:In one case,a large consolidation was seen in right middle lobe and a large pulmonary bulla with infection was seen in right lower lobe.In another case,there was uniform distribution of lesions from hilum to pleura.Right upper lobe atelectasis was accompanied with cylindric bronchiectasis and irregular cavity.Conclusion:The major CT manifestations of NTM pulmonary disease were bronchiectasis and bronchiolitis.A few patients showed other signs:large patchy consolidation or multiple nodules.更多还原