支气管内膜结核的CT诊断分析(1)
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[摘要] 目的：分析支气管内膜结核(EBTB)的CT影像学表现特征，提高对EBTB的CT诊断能力。方法：回顾性分析60例经纤支镜、病理证实EBTB的胸部CT的不同表现，探讨支气管本身异常及周围结构的改变。结果：60例EBTB患者肺野内有肺结核灶者56例。主要征象是肺叶或肺段支气管不同程度阻塞或狭窄、支气管壁增厚，肺门区无肿块及反S征。支气管狭窄共72处，狭窄段超过3 cm有38处，狭窄伴肺叶或肺段不张40例，其中不张或实变区可见充气支气管征及支气管扩张28例，肺门及纵隔淋巴结肿大或钙化16例，支气管壁钙化11例，合并胸膜病变24例。结论：EBTB的CT表现具有一定的特征性，可为临床诊断和鉴别诊断提供重要的依据。
[关键词] 支气管内膜结核；CT；诊断
[中图分类号] R816.4 [文献标识码] B[文章编号] 1673-7210(2010)11(b)-072-03
Computer tomography diagnostic analysis of endobronchial tuberculosis
JIANG Shunzhou1, ZHANG Yunxuan2
(1.The Hospital of No.15 Metallurgical Construction Co., Ltd of Huangshi City, Hubei Province, Huangshi 435001, China; 2.CT Room of the Second Hospital of Huangshi City, Huangshi 435002, China)
[Abstract] Objective: To analyse CT imaging features of endobronchial tuberculosis (EBTB) and improve the diagnostic ability of the EBTB. Methods: 60 cases different clinical chest CT scanning proved by bronchofiberscope and pathology were analysed retrospectively, and to explore bronchial itself abnormal and the surrounding structure changes. Results: There were 56 patients with pulmonary tuberculosis(TB) focus in lung field in 60 patients with EBTB. These major sings were pulmonary lobe or segmental bronchi with different degree blockage or angusty, bronchial wall thickening, hilus of the lung without tumor and anti-S sign. A total of 72 bronchial stenosis, 38 bottleneck stricture more than 3 cm. There were 40 cases with stricture accompanying with atelectasis, among pulmonary lobe and segment, it was thus clear that 28 cases with aerate bronchi distinction and bronchiectasis, Hilar and mediastinal lymph node enlargement or calcification in 16 cases, bronchial wall calcification in 11 cases, 24 cases of combined with pleural disease. Conclusion: CT performance of EBTB are with certain characteristics, and it is important for clinical diagnosis and differential diagnosis.
[Key words] Endobronchial tuberculosis; CT; Diagnosis
支气管内膜结核(endobronchial tuberculosis，EBTB)较常见，是以侵犯肺叶、肺段支气管黏膜为主，引起阻塞性肺不张的一种结核性疾病，是肺结核的一种特殊类型[1]，临床征象缺乏特异性，临床误诊、漏诊率较高。本文结合文献资料对经纤支镜及病理证实的60例EBTB的各种CT表现特征进行回顾性分析 ......
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