免疫功能低下疾病患者肺结核的影像分析

目的探讨几种免疫功能低下疾病的肺结核患者的X线和CT所见。方法回顾分析糖尿病患者68例,肾病综合症患者20例,SLE患者12例,8例AIDS患者合并肺结核的X线及胸部CT所见。结果X线和CT表现,糖尿病肺结核:大片浸润病灶45例,浸润病灶内多发空洞40例,散在大小不等浸润病灶可不按肺段分布23例,支气管播散病灶21例;部分病例合并胸水10例。肾病综合症或SLE肺结核:急性血行播散性肺结核15例,大小不等浸润病灶17例,合并肺门及纵膈淋巴结肿大4例;AIDS肺结核:肺内斑片阴影合并有淋巴结肿大5例,急性血行播散性肺结核合并有淋巴结肿大3例。结论免疫功能低下疾病患者的肺结核,肺内结核病灶容易形成大片干酪病灶并合并空洞,结核肺内播散,急性血行播散性肺结核,肺门及纵膈淋巴结肿大及非结核好发部位发生浸润结核灶。

Analysis on imaging features Of pulmonary tuberculosis in immune hypofunction patients

Objective To evaluate X-ray and CT features Of pulmonary tuberculosis in diabetic patients,patients with dropsical nephritis,patients with systemic lupus erythematosus(SLE),and patients with acquired immunodeficiency syndrome(AIDS).Method Retrospective analysis were done on CT scans and X-ray features Of pulmonary tuberculosis cases combined with 68 with diabetiC(68),with dropsical nephritis(20),with SLE(12),with AIDS(8).Results X-ray and CT features of pulmonary tuberculosis combined With diabetic included larger infiltrate consolidation(45 cases),multiple cavities with infiltrate consolidation(40 cases),nosegmental distribution(23 cases),bronchi disseminate focus(21 caseS),and pleural fluid(10 cases).The X-ray and CT appearances of pulmonary tuberculosis patients combined with dropsical nephritis or SLE inclUded acute hematogenous dissemination pulmonary tuberculosis(15 cases),vary sized infiltrate consolidation(17 cases),complicating lymphadenectasis in hilum of lung and mediastinum(4 cases).The CT findings of pulmonary tuberculosis combined with AIDS were patch shadow complicated With lymphadenectasis(5 cases),and acute hematogenous dissemination pulmonaryary tuberculosis complicated with lymphadenectasis(3 cases) Conclusion The main radiological findings of pulmonary tuberculosis in immune hypofunction patients appear larger infiltrate consolidation,multiple cavities within infiltrate consolidation,bronchi disseminate,acute hematogenous dissemination pulmonary tuberculosis,lymphadenectasis in hilum of lung and mediastinum,and infiltrate tuberculosis consolidation in uncommon parts.