气管支气管结核的多层CT诊断

分析气管支气管结核的多层CT(MSCT)表现,并探讨其诊断价值.材料和方法:回顾性分析38例(男12例,女26例,年龄14～53岁,中位数33岁)气管支气管结核,23例经组织学证实,15例经痰菌检查结合多种其他方法临床证实.MSCT检查采用5mm、2.5mm或lmm准直螺旋扫描,结合2.5mm或lmm的薄层扫描,22例做了增强扫描,全部病例均完成了至少2种后处理;32例同期完成了纤维支气管镜检查.5例瘢痕狭窄行支架治疗,治疗前后均行CT检查.结果:38例共检出58支病变,多支受累率44.7%(17/38);支气管狭窄44例,狭窄长度2cm以上93.2%(41/44);管壁不规则增厚,有时见腔内结节;多数(35/38)伴肺内结核病灶;可伴肺门纵隔淋巴结肿大.MSCT结合各种后处理技术可以有效显示病变特征,并特别有助于支架治疗前后气道通畅性的判断.结论:MSCT结合后处理技术可以有效显示气管支气管结核的特征,有助于诊断,并特别有助于支架治疗前后气道狭窄的判断.

Multislice CT Diagnosis of Tracheobronchial Tuberculosis

Purpose: To study the multi - slice CT (MSCT) features of tracheobronchial tuberculosis (tTB) and to explore the diagnostic value of MSCT.Materials and Methods: Thirty - eight patients with tTB were reviewed retrospectively. Among them, 23 cases were confirmed by histology, 15 cases of tuberculosis bacillus positive or confirmed by other clinically methods, MSCT were performed using 5, 2.5 or 1 mm collimation, and at least two kinds of postprocessing were used. 22 patients undertake enhanced CT. 32 cases findings were compared with endoscopic and biopsy synchronizely. 5 cases stent placement of ci-catricial stenosis were observed too.Results: There were 55 lesions in 38 cases, and 44.7% multiple involvements of 2 or more bronchi. Stenosis were found in 44 bronchi and a long segment involved mostly (93.2%) . The diseased tracheobronchi appeared as irregular stenosis. Some cases demonstrated thickening of the bronchial wall and intraluminal prominences. Active lung parenchymal TB were accompanied in most cases (35/38). It might be accompanied by enlarged hilar or mediastinal lymph nodes. MSCT with the postprocessing displayed the features of tTB effectively and help making a correct diagnosis on CT, especially for the stent placement. Conclusion: MSCT combined with its postprocessing images is a valuable diagnostic procedure to reveal tTB, can clearly demonstrate the lesion and make it fully apprehended. Combination of the axial and postprocessing can be helpful to evaluate the lesion perfectly.