89例X线胸片误诊肺结核的CT分析

目的探讨X线胸片误诊肺结核的原因及CT对肺结核的诊断价值。方法对X线胸片误诊而经临床确诊并具有完整临床、影像资料的肺结核病例89例进行X线胸片和CT对照回顾性分析。结果(1)X线胸片下肺叶病灶占44.9%,CT显示下叶基底段病灶最多,占32.0%。(2)胸部CT发现X线胸片漏检早期肺结核病灶11.8%、肺内隐匿部位病灶43.3%和早期粟粒性结核6例。(3)胸部CT对肺结核血行播散及支气管播散、支气管壁增厚、胸膜增厚及粘连、纵隔淋巴结肿大及钙化的显示率明显高于X线胸片。结论CT检查对肺结核诊断及鉴别诊断具有重要价值,建议在X线胸片诊断不明确时及时作CT检查。

CT analysis on tuberculosis X-ray misdiagnosed cases

Objective To determine the cause of X-ray misdiagnosed cases and the diagnostic value of CT in pulmonary tuberculosis.Methods A retrospective analysis was done through comparing the clinical information,X-ray film and CT film of 89 patients with pulmonary tuberculosis.Results The lesions showing finding in X-ray included prime tuberculosis(11.8%),intrapulmonary invisible location(43.3%),and prime blood spread(n=6),but were completely presented in chest CT films.The blood spread lesions,bronchogenic spread lesions,thickened wall of bronchus,pleural thickening,inner-mediastinum lymph node enlargement and calcification in chest CT films showed higher rate than that of X-films.Conclusion The value of chest CT for providing evidences for diagnosis and in differentiating diagnosis of TB is very important.We suggest that we should do CT detection in time when X-films showed and no positive in diagnosis.