支气管内膜结核的CT表现

目的　分析支气管内膜结核 (EBTB)的CT表现 ,提高对EBTB的认识。资料与方法　回顾分析 18例经纤维支气管镜、病理证实的EBTB的胸部CT表现 ,探讨支气管本身的异常以及肺实质、淋巴结和胸膜改变。结果　共 2 1处支气管受累 ,右肺多于左肺 ,累及下叶最多。支气管壁增厚 16处 ,管腔狭窄 13处 ,累及较长段者 (>3cm) 10处 ,管壁增厚、局部管腔扩大 5处。 5例继发肺不张 ,11例并存支气管播散灶。所有患者肺野内均可见陈旧性肺结核灶 ,8处病灶为活动性 ,15例并发胸膜病变。肺门纵隔淋巴结肿大 9例。结论　较长段的支气管壁中心性增厚为EBTB的主要表现 ,多数并存肺实质和胸膜病变 ,淋巴结环形强化为其特征

CT Features of Endobronchial Tuberculosis

Objective To describe CT signs of endobronchial tuberculosis (EBTB) and to make a further understanding of the disease.Materials and Methods Thoracic CT findings in 18 cases with pathologically-proved EBTB were retrospectively analyzed. The abnormalities of the bronchi, pulmonary parenchyma, lymph nodes and pleurae were observed.Results A total of 21 bronchi was affected. The right lung was more affected than the left lung, with the lower lobes being most frequently involved. Bronchial wall thickening was seen in 16 sites, bronchial stricture and occlusion in 13 and 5 sites, respectively. The diseased segment of the bronchus was over 3cm in 10 sites. Thickened wall with localized dilatation of the bronchus was present in 5 sites. Secondary atelectasis (n=5) and bronchial dissemination (n=11) were observed. Old pulmonary tuberculosis was present in all patients, and fresh tuberculous lesions in 8 patients. Pleural lesion was noted in 15 cases. Mediastinal or hilar tuberculous lymphadenitis was demonstrated in 9 cases. Conclusion Concentric bronchial wall thickening which affects a certain segment of the bronchus is the main sign of EBTB. Pulmonary and pleural lesions are coexisted in most cases. Circle enhancement of the lymph nodes is characteristic.