右肺中叶结核的CT诊断（附7例报告）

目的提高对右肺中叶结核的CT诊断能力。方法对手术及穿刺肺活检病理证实的7例右肺中叶结核资料进行回顾性分析,常规10mm层厚扫描后,3例行病灶5mm薄层扫描。结果病灶位于中叶外段5例,内段2例。类肿块状6例,片状1例。边缘不规则4例,部分不规则2例,边缘光滑规则1例。密度均匀4例,不均匀3例。7例中钙化2例,支气管充气征1例,蜂窝状透光区1例,胸膜肥厚5例。结论成人右肺中叶结核属非好发位及不典型表现的肺结核,诊断有一定难度,结合病史综合分析,可以发现有价值的诊断依椐。

CT diagnosis of tuberculosis in right middle lung lobes:report of 7 cases

Objective To elevate the capability of CT scan in diagnosing tuberculosis（TB） in right middle lung lobes.Methods Seven patients with surgically or histopathologically proved TB underwent CT scans of the chest at 10 mm of slice thickeness,subsequently 3 patients underwent additional thin slice（3 mm） scans.The CT findings of all the patients were analyzed retrospectively.Results Among 7 patients,the TB lesions of 5 cases were located in lateral segments of right middle lobes,while those of 2 cases were located in medial segments of right middle lobes;tumor-like lesions in 6 and patchy lesion in 1;well-difined margin in 4 and ill-defined margin in 3;homogeneous density in 4 and heterogeneous density in 3;intralesional calcification in 2,air bronchogram in 1,honeycombing transparent area in 1,and pleural thickening in 5.Conclusion For adult TB,the right middle lung lobe is referred to rare site and atypical manifestation and therefore there is a certain difficult in its diagnosis,however,a comprehensive analysis of CT findings combined with clinical history will likely find valuable evidence to dignose this disease.