不典型肺结核的影像学误诊分析

目的分析影像学表现不典型的肺结核误诊的原因,总结不典型肺结核的X线与CT表现。方法49例误诊病例中男性30例,女性19例,年龄16～89岁。均行X线平片与胸部CT平扫,并与病理对照,找出误诊原因。结果49例肺结核误诊为肺癌29例,肺炎16例,其他疾病4例。误诊病例中影像学表现为结节和肿块病灶18例,肺段或肺叶阴影24例,肺门及纵隔肿块7例。结论影像学表现不典型、CT检查不全面及未与胸部平片表现综合分析是本组不典型肺结核误诊的主要原因。

Analysis on Imaging Misdiagnosis of Atypical Pulmonary Tuberculosis

Objective To investigate X-ray and CT charaeteristics of atypical pulmonary tuberculosis and analyze the reasons of misdiagnosis in patients with atypical pulmonary tuberculosis. Methods The patients in this study included 30 man and 19 women,with ages ranging from 16 to 89 years old. Chest CT scans were performed in all patients. The CT films were contrasted with pathologic findings,so as to find the misdiagnosis reasons. Results 29 cases and 16 cases were mistaken for lung cancer and pneumonia, and 4 cases were diagnosed as other diseases by mistake. In misdiagnosed patients＇ CT films, 18 cases were noduses and masses,24 cases had pulmonary shadows,and 7 cases had masses in hilum lung and mediastinum. Conclusion The main causes of misdiagnosis of pulmonary tuberculosis are atypical radiological appearance on X-ray and CT films, and lacking of combination of CT findings with that of chest radiography.