【摘要】 目的 分析青少年肺结核爆发感染早期无症状活动性肺结核的CT征象。方法 回顾性分析苏北某县寄宿式高中爆发肺结核感染后,参加肺结核筛查并经临床诊断为活动性肺结核的47例患者的临床、胸部X线、CT表现并与治疗后CT表现进行对照。结果 47例早期无症状活动性肺结核中男性发病率高于女性,27例胸部X线未发现异常病变,X线和CT对早期活动性肺结核检出率的差异有统计学意义(P<0.001)。47例中,46例胸部CT表现为肺实质病变,1例表现为胸腔积液,共58个肺叶60个肺段存在病变,35例病变位于上叶,22例病变位于下叶,1例病变位于中叶,其中CT表现为树芽征占68.1%,微结节占89.4%,实变占21.3%,抗结核治疗后病灶不同程度吸收好转。结论 青少年有肺结核接触史者胸部CT检查显示肺内微结节或树芽征时要首先考虑活动性肺结核。更多还原

【Abstract】 Objective To analyze the CT features in the early stage of asymptomatic active pulmonary tuberculosis(PTB) in adolescence after PTB outbreak.Methods After PTB outbreak in a boarding school of a certain county in northern Jiangsu province,the clinical data,X-ray and CT findings of 47 cases with active PTB were analyzed retrospectively and compared with CT findings after treatment.Results In 47cases,the incidence of male was higher than that of female,and 27 cases were negative on chest X-ray.The difference of X-ray and CT detection rate in the early stage of active PTB was statistically significant(P<0.001).Of 47 cases,46 patients had pulmonary parenchymal lesions and 1 had pleural effusion on CT.The lesions were found on 58 lobes and 60 lung segments,and 35 cases demonstrate lesions on the upper lobes,22 cases on the lower lobes,1 case on the middle lobe.CT images showed tree-in-bud opacities(68.1%),micronodules(89.4%)and consolidation(21.3%).All of patients got better after antituberculous therapy.Conclusion Active PTB should be considered first when CT scan shows micronodules or tree-in-bud signs in adolescences with PTB exposure.更多还原