气管支气管内膜结核的CT诊断

目的：分析气管支气管内膜结核的CT表现，探讨其影像学特征及其病理基础。方法：收集痰菌、病理及临床证实的气管与支气管结核52例，分析其CT与HRCT表现。结果：CT表现有以下特点：①96．1％CT显示长段不规则气管或支气管壁增厚，其增厚的支气管壁范围较长为特征之一；②25％CT显示远处肺或对侧肺结核支气管播散病灶；③支气管狭窄、阻塞不伴有肺门肿块；④11．5％可见增厚的气管或支气管壁出现钙化。此征象具有特征性；⑤支气管阻塞性肺部病变中，若出现阻塞性肺气肿伴气肿区分支条状或指套样高密度灶、支气管阻塞远端实变、肺内或不张肺内出现大量无壁空洞、“蜂窝样”改变或伴有不规则或“串珠状”支气管扩张表现者也具有一定特征性诊断价值，其中后者考虑为继发于支气管壁破坏或实变与不张肺内病灶纤维化继发的牵拉性支气管扩张所致。结论：气管支气管内膜结核的CT表现，尤其是HRCT表现，有一定特征性，是诊断及鉴别诊断的有效于段。

CT diagnosis of tracheobronchial tuberculosis

Objective: To explore the CT features and the pathological basis of tracheobronchial tuberculosis by analyzing its CT imagings.Methods: The CT and HRCT manifestations of 52 patients with tracheobronchial tuberculosis proved by mycobacterium tuberculosis in sputum,pathology and clinic,were analyzed.Results: CT and HRCT features of tracheobronchial tuberculosis were as follows: ①Long range of irregular thick wall of tracheobronchial was found in 96.1%,which was companied with long range of stenosis and obstruction of bronchus;②Bronchial disseminated lesions in the distant lung or the opposite side lung were seen in 25%;③Bronchus was found stenosis or obstructive without hilar mass;④Calcification was found in the thicking bronchial wall in 11.5%;⑤In obstructive pulmonary focuses,the obstructive emphysema patient often accompanied with branch strip shape or finger stove sign in the emphysema area.The obstructive pneumonia or atelectasis often accompanied with irregularly the honeycomb-shaped change and the bronchiectasis change in the solid area.Conclusion: The CT features of tracheobronchial tuberculosis,in particular,the HRCT features,have certain characteristic,it is an effective means for diagnosis and differential diagnosis.