空洞性肺结核的X线及CT影像对照分析

目的:比较和评价常规X线、CT扫描两种影像学方法在空洞性肺结核诊断中的价值。方法:回顾性分析45例空洞性肺结核的X线、CT影像表现,其中18例痰菌阳性证实,15例经纤维支气管镜检查证实,12例经临床证实。结果:(1)45例中共有69个大小不等空洞,其中X线平片显示30个空洞,CT显示69个,空洞大小为2mm～45mm。(2)空洞性肺结核的好发部位为两肺上叶尖后段及下叶背段。(3)X线平片显示空洞周围卫星病灶27例,CT38例。(4)X线显示空洞引起肺内支气管播散7例,CT15例。(5)X线显示结核空洞外侧胸膜增厚4例,CT12例。(6)CT显示纵隔内淋巴结肿大4例。结论:CT在显示空洞的位置、数目、大小、形态、洞壁厚薄、洞内外细节及结核沿支气管播散等方面优于X线平片。X线平片拟诊肺结核的患者宜行CT作进一步检查。

Comparative Analysis of Routine X-ray and CT Scan in Diagonsis of Cavitary Pulmonary Tuberculosis

Objective To compare the routine X-ray film and CT scan in diagnosis of cavitary pulmonary tuberculosis.Methods Analyzing X-ray and CT appearance of 45 cases of cavitary pulmonary tuberculosis retrospectively,18 cases were confirmed by sputum examination, 15 cases were confirmed by bronchoscope,12 cases were confirmed by clinically.Results There were 69 cavities in the 45 cases of cavitary pulmonary tuberculosis ,30 cavities were showed by X-ray film, 69 cavities were showed by CT scanning, the cavities were 2 mm～45 mm in diameter.Cavitary of pulmonary tuberculosis predominantly involved apical and posterior segments of upper lobes, superior segments of lower lobes.27 cases of satellite lesions were showed by X-ray film, 38 cases by CT scanning.7 cases of mean while dissemination lesion in lung were found by X-ray film,15 cases by CT scanning.4 cases of adjacent cavity pleural thickness were demonstrated by X-ray, 12 casesby CT. 4 cases of lymph node enlargement in mediastinum were showed by CT.Conclusion CT scanning is superior to X-ray in diagnosis of cavitary pulmonary tuberculosis, especially in showing the location, number,size, shape, wall, inside and outside lesion, and dissemination lesion in lung of the cavities. The patient of pulmonary tuberculosis by X-ray should be checked by CT scanning.