高分辨CT扫描对气管、支气管结核的诊断价值及临床意义

目的　探讨HRCT对气管、支气管结核的诊断价值及临床意义。方法 对32例诊断明确的气管、支气管结核住院患者行胸部HRCT扫描,结合纤维支气管镜检查,观察病变气道内壁及管腔的形态变化以及其病变远侧肺实质的病变情况。结果 气管、支气管壁病变检出率为73.9%,其中管壁轻度增厚54.3%,明显增厚19.6%;气道管腔形态改变检出率为67.4%,其中管腔狭窄<50%的41.3%,>50%的19.6%,管腔闭塞6.5%。同时观察到气管、支气管周围及纵隔淋巴结肿大7例,病变支气管远侧管腔内粘液栓12例,管腔局限性扩张5例,小叶性肺气肿18例,肺不张2例,肺内结核病灶39例。结论 HRCT检查观察气道病变部位和范围、气道病变与肺内病变的关系、危重患者纤维支气管镜检查前的定位准备及估计预后均有重要的临床意义。

The diagnostic value and significance of the HRCT scan in tracheo brochial tuberculosis

Objective To assess the significance of high resolution computed lomography (HRCT) scan in the diagnosis of the tracheobronchial tuberculosis.Methods The HRCT findings of 32 cases with tracheobronchi tuberculosis were analyzed,and observing the formal changes of the wall and cavity in tracheobronchial and the pathological changes in the lungs.Results The diagnosis rate with the changes in the tracheobronchial wall was 73.9%,of which the slight thickened of the tube wall was 54.4% and obviously was 19.8%,the changes in the cavity was 67.4%,of which the narrowing <50% was 41.3%,>50% was 19.6% and obliteration was 6.5%,meanwhile it were observed that the enlarged lyphnode around the tracheobronchi and mediastinum was 7 cases,mucus embolism in the tube was 12 cases,local enlargement of the tube was 5 cases,lobular emphysema was 18 cases and tuberculosis focus in the lung was 39 cases.Conclusion The HRCT scan was of clinical significance in observing the pathological changes of tracheobronchi and evaluating the relationship between the lung focus and tracheobronchi lesions,prepare doing the FB examining for the weak patients and evalute the prognosis of the patients.