【摘要】 分析空洞性肺结核的ＣＴ表现和特征，探讨ＣＴ诊断该病的可靠性。材料与方法：２１例空洞性肺结核病人均做胸部ＣＴ和胸片检查，分析ＣＴ所见并与病理、胸片对照，１０例经组织病理学证实，１１例痰检和临床证实。结果：（１）两肺上叶尖后段及下叶背段为空洞性肺结核的好发部位；（２）空洞呈圆形成椭圆形，空洞外壁较光整，空洞壁常有钙化：（３）空洞所属支气管壁不规则增厚：（４）临近空洞胸膜局限性增厚；（５）空洞以外肺组织内有支气管播放或活动性病灶。本组病例ＣＴ征象典型可正确论断者占４８％：ＣＴ表现不典型，但可提示结核者占２９％：ＣＴ表现无特征，不能正确诊断者占 ２３％。结论： ＣＴ是发现和诊断空洞性肺结核的有效方法，对 ＣＴ表现不典型者可结合支气管镜、痰结核菌检查提高诊断正确性。更多还原

【Abstract】 Purpose: To study CT features of the cavitary pulmonary tuberculosis and assess the value of CT diagnosis. Materials and methods: CT and plain films were performed in 21 cases with cavitary pulmonary tuberculosis confirmed by pathology or clinic. The CT findings were compared with pathologic and plain film findings. Results: (1) Cavity of pulmonary tuberculosis predominantly involved apical and posterior segments of upper lobes. superior segments of lower lobes. (2) The cavity appeared as round or ellipse. The out wall usually was smooth. The calcification on the cavitary wall was often found. (3) Thickening of the involved bronchial wall were showed. (4) Adjacent pleural thickness were demonstrated. (5) Endobrochial spread manifestation and active lung parenchymal TB were showed outside cavity. 48% of cases had typical CT features and could make a correct diagnosis. In 29%. CT appearances were atypical but suggestive of the diagnosis. In 23%. the correct diagnosis was difficulty to be made by CT. Conclusion: CT is an effective method in diagnosis of pulmonary tuberculosis. The diagnostic accuracy can be improved for atypical CT findings in combining with bronchoscopy. and sputum examination.更多还原