显微镜下多血管炎的胸部CT表现

目的 提高对显微镜下多血管炎（MPA）胸部CT表现的认识。方法 回顾性分析5例明确诊断的MPA胸部CT资料。所有病例均行胸部常规CT检查，其中4例行高分辨率CT（HRCT）扫描。结果 胸部CT主要表现为磨玻璃影3例，实变影2例，纤维化2例，肺大泡3例，胸膜增厚3例，胸腔积液2例，胸内淋巴结增大3例；外周型为主3例，中央型及无明显区域分布各1例。2种及以上肺部病变并存4例。肺部病变合并纵隔淋巴结增大的3例。结论 MPA胸部CT无特异性，主要表现为磨玻璃影，明确诊断需结合临床、影像表现和实验室检查。     

CT appearances of abdominal tuberculosis

The purpose of this article is to review and illustrate the spectrum of computed tomography (CT) appearances of abdominal tuberculosis. Tuberculosis can affect any organ or tissue in the abdomen, and can be mistaken for other inflammatory or neoplastic conditions. The most common sites of tuberculosis in the abdomen include lymph nodes, genitourinary tract, peritoneal cavity and gastrointestinal tract. The liver, spleen, biliary tract, pancreas and adrenals are rarely affected, but are more likely in HIV-seropositive patients and in miliary tuberculosis. This article should alert the radiologist to consider abdominal tuberculosis in the correct clinical setting to ensure timely diagnosis and enable appropriate treatment.     

CT appearances in macronodular hepatosplenic tuberculosis: A review with five additional new cases

Pseudotumoral or macronodular hepatosplenic tuberculosis (HSTB) is rare. Only 31 cases have been documented in imaging literature so far. Presented is the clinico-imaging review with five additional new cases of this uncommon variety. Due to nonspecific wide spectrum of imaging appearances, biopsy is mandatory in almost all cases. Clinical recovery and resolution of lesions on imaging may not be directly proportional.     

支气管内膜结核的CT表现

目的:分析支气管内膜结核(EBTB)的CT表现,以提高对EBTB的认识。方法:回顾分析了45例经纤支镜及病理证实的EBTB的胸部CT表现,探讨支气管本身的异常及肺实质、淋巴结以及胸膜的改变。结果:45例病人CT片上共显示92处支气管受累,包括右侧54处和左侧38处,其中28例显示两支以上的受累支气管,11例主、叶、段多支支气管同时受累。38例表现为支气管狭窄,狭窄程度为轻度20例、中度12例和重度6例。8例继发肺不张,30例并存支气管播散灶。所有患者肺野内均可见陈旧性结核灶,28例并发胸膜病变。肺门纵隔淋巴结肿大15例。结论:较长段的支气管管壁中心性增厚或主、叶、段多支支气管受累为EBTB的主要表现,多数并存肺实质和胸膜病变,引流区淋巴结可增大。     

Chest wall Castleman's disease: CT and MRI findings

Castleman's disease is an usually benign lymphoid tumor of uncertain etiology that generally appears as a solitary mediastinal mass. We present a case of Castleman's disease in the right chest wall of a 60-year-old woman. Magnetic resonance imaging showed a well-defined, oval mass that was early enhanced on T1-weighted images. The mass was diagnosed by percutaneous core needle biopsy with computed tomography guidance. The patient has remained well for 5 years without an increase in tumor size. We also summarize the international literature.     

Prostate brachytherapy seed migration to the right ventricle: Chest radiographs and CT appearances

Transperineal interstitial prostate brachytherapy is increasingly used as a definitive treatment for early prostate cancer. After this treatment, seed migration to the heart is rarely frequently observed. The patient was experienced seed migration to the right ventricle after the treatment, it was difficult to diagnose in posteroanterior chest radiograph, but we were able to demonstrate it in multi-detector row computed tomography (MDCT).     

Mediastinal and heart wall invasion by actinomycosis: CT and MRI appearances

Widespread use of antibiotics facilitates the development of some uncommon chronic infections such as actinomycosis. The clinical and radiographic findings overlap those of other inflammatory and neoplastic conditions. With a review of the literature, we report the CT and MRI findings in a case of thoracic actinomycosis, presenting with right ventricular failure caused by heart involvement. CT was helpful in identifying the mediastinal extent of the disease and in demonstrating the absence of pulmonary involvement. MRI, however, offered complementary information, especially in assessing heart involvement without the need for intravenous contrast media. On T2-weighted images the mediastinal process was noted to be of relatively low signal intensity, possibly indicating its benign nature. The association with heart involvement was suggestive of thoracic actinomycosis. Correspondence to: C. Fisch     

肺结核不典型CT表现误诊分析

目的：对肺结核不典型的CT影像特点进行分析以总结误诊原因。方法：24例肺结核均行CT平扫，其中2例做增强扫描，全部经临床或病理确诊。结果：按CT表现分3型；（1）结节／肿块型16例，边缘光滑9例，毛糙4例，浅分叶3例；（2）片状实变型5例，形态不规则，密度均匀，边缘模糊；（3）肺不张型3例，表现为叶或段支气管狭窄或闭塞，肺组织体积缩小。结论：肺结核的发病出现新趋势，老年结核增多。其影像表现多样，应根据各种征象进行综合分析，避免误诊为肺癌。     

Chest wall invasion by lung cancer: limitations of CT evaluation

Thirty-three patients with peripheral pulmonary malignancies contiguous with a pleural surface were evaluated for chest wall invasion by computed tomography (CT). CT criteria included pleural thickening adjacent to the tumor, encroachment on or increased density of the extrapleural fat, asymmetry of the extrapleural soft tissues adjacent to the tumor, apparent mass invading the chest wall, and rib destruction. The CT scans were classified as positive, negative, or equivocal for invasion, and a decision matrix was constructed comparing CT results with pathologic data. The sensitivity of CT was 38%, specificity was 40%, and accuracy was 39% for evaluation of invasion if equivocal CT results were counted as radiologic errors. CT scanning has low accuracy in assessing chest wall invasion in patients with peripheral lung cancers.     

CT appearances in abdominal tuberculosis. A pictorial essay.

Abdominal tuberculosis continues to be endemic in the developing world and has shown a resurgence in the West. Computed tomography (CT) evaluation is singularly informative as it demonstrates involvement of the bowel, peritoneum, lymph nodes, and solid organs in a single examination. A spectrum of CT findings in an immunocompetent population is presented, ranging from subtle to advanced and common to rare. Genitourinary tuberculosis and tuberculosis in AIDS are excluded as they merit separate discussions.     

肺结核初治中的类赫反应CT影像分析

目的 探讨肺结核初治中类赫反应的CT特征.方法 回顾性分析44例经临床证实的肺结核初治中出现类赫反应患者的CT资料,治疗前后均经CT平扫、薄层及高分辨CT扫描,17例行CT增强扣描.结果 全部患者按发病部位共57处统计例数,表现为肺内病变进展(原发病变范围扩大或新发片状影、胸膜下球形影)28例,胸膜病变(胸腔积液、胸膜结核球)10例,心包增厚1例,淋巴结肿大15例,胸腺反应3例.发生时间为20 d至3.5个月,最短出现时间为20 d;继续原方案治疗1.0～3.0个月病变好转或消失,其中3.0个月内消失37例(84%).结论 类赫反应具有一定CT影像特征.     

Female genital tuberculosis: hysterosalpingographic appearances

Genital tuberculosis is an important cause of infertility in developing countries and hysterosalpingography (HSG) is the initial procedure performed for the evaluation. Reviewing 37 cases of female genital tuberculosis, we encountered various appearances on HSG. Of 579 HSGs performed over a period of 4 years, 492 (85%) were performed as part of infertility work up. Genital tuberculosis was found in 6.3% of all the patients who underwent HSGs and 7.5% of all patients investigated for infertility. The various features of proven tuberculosis cases are illustrated in this pictorial review. We briefly discuss the pathology and these appearances along with radiopathological correlation.     

72例SARS的胸部X线影像分析

目的 研究严重急性呼吸综合征(SARS)患者X线胸片的改变和影像动态变化。方法对72例SARS的X线表现进行分析，包括X线胸片异常出现的时间、病变最为严重的时间及病变吸收的时间和影像形态。结果胸部X线异常出现的时间多在发病后的4～7d(53例，73．6％)，X线表现最为严重的时间多在发病后的8～14d(54例，75．0％)，多数病变吸收的时间多为发病后的15～21d(37例，51．4％)，病变的主要特点是以双侧或单侧的单发或多发大片状模糊影(58例，80．6％)，最严重时期变化快。部分病人病变呈游走性改变。X线片上病变吸收后1个月内CT证实肺内仍具有病变者占55．0％(11／20例)。结论胸部X线片可反映SARS患者病变的动态变化，但对病变的细微改变显示有限度。     

胸壁结核的CT诊断和分型

目的总结分析31例胸壁结核(不包括胸椎结核)的CT征象并探讨其CT分型,以提高对该病的认识和诊断能力。方法收集经手术或穿刺病理证实的31例胸壁结核患者的资料,回顾性总结分析CT影像特征。结果按照病变的CT表现分为4型,Ⅰ型:胸膜结核球,12例;Ⅱ型:肋骨或胸骨结核,7例;Ⅲ型:胸壁前部结核性脓肿,8例;Ⅳ型:全胸壁结核,4例。结论CT能清楚显示胸壁结核的累及范围和密度变化,有利于病变定性和鉴别诊断,并能够准确地提供分型。     

胸部X线摄影术与CT诊断胸壁结核的对照研究

目的评价胸部X线摄影术及CT在胸壁结核诊断中的价值。方法对21例经手术、穿刺活检证实的胸壁结核作了影像学分析，其中男8例，女13例，年龄在19—84岁，中位年龄34岁；全部病例均作了胸部X线摄影术和CT扫描，9例作了增强CT扫描。结果（1）胸部X线平片仅4例显示骨质破坏。（2）CT平扫则全部可见肋骨旁软组织肿块；16例边缘密度较高，中央密度较低，3例呈较高密度中有多发低密度，2例呈均匀较低密度。5例肋骨破坏，3例为膨胀性溶骨性骨破坏。增强扫描时8例肿块呈边缘强化。（3）21例CT所见的胸壁肿块，胸片均未能发现（X^2=42．000，P〈0．01）；4例CT上可见的4个纵隔及腋窝肿大淋巴结，胸片上均未能见到（X^2=4．421，P〈0．05）；2种影像学检查差异具有统计学意义。结论CT，特别是增强CT扫描是确诊本病的首选方法。     

Comparative appearances of non-tuberculous mycobacteria species: a CT study

Our objective was to characterise the CT features of the various species of non-tuberculous mycobacteria (NTM) and to identify differences, if any, between Mycobacterium avium intracellulare (MAI) and other species. Fifty-five patients, who were culture positive on at least two occasions for a single NTM species, were evaluated. All patients had CT scans performed within 6 months of NTM identification. The CT scans were assessed for the presence and severity of bronchiectasis, nodules, cavities, tree-in-bud pattern, consolidation and for evidence of pre-existing lung disease. Bronchiectasis was identified in most patients (52 of 55, 95%) and nodules were present in approximately half (29 of 55, 53%). Patients with MAI (n=16) were found to have significantly higher bronchiectasis scores and higher prevalence of nodules than the other species (both p<0.01). Patients with M.kansasii (n=9) and M.xenopi (n=9) had cavities, tree-in-bud pattern, and pre-existing emphysema as the dominant CT features. Patients with M.chelonae and M.fortuitum were younger than the other groups and also had a high incidence of pre-existing lung disease. Patients with MAI infection have more severe bronchiectasis and more nodules on CT than the other NTM species. Morphological differences between the other species were identified but were less distinct. Electronic Publication