本文選題：肺疾病　切入點：肺間質(zhì)病變　出處：《放射學(xué)實踐》2017年04期

【摘要】：目的:探討以肺間質(zhì)改變?yōu)橹鞯姆谓Y(jié)核HRCT表現(xiàn),提高其影像診斷水平。方法:回顧性分析100例已確診為肺結(jié)核患者的影像學(xué)資料,所有患者以肺間質(zhì)改變?yōu)橹?總結(jié)這類患者的HRCT特點。結(jié)果:100例中病變共累及361個肺段,右肺上葉尖段和后段(52例,14.4%)、左肺上葉尖后段(48例,13.3%)、右下葉基底段(53例,14.9%)和左下葉基底段(51例,14.1%)是主要受累部位。病變在雙肺彌漫性分布35例。將所有病變按部位(好發(fā)部位和非好發(fā)部位)分為2組,好發(fā)部位組中病變沿葉段中央分布共151個肺段(44.9%),葉間胸膜旁分布112個肺段(33.3%),明顯多于胸膜下分布的73個肺段(21.7%);非好發(fā)部位組中沿葉段中央分布共86個肺段(31.5%),葉間胸膜旁分布79個肺段(28.9%),胸膜下分布108個肺段(39.6%);兩組間差異有統(tǒng)計學(xué)意義(χ~2=24.037,P0.001)。按間質(zhì)類型分析:軸心間質(zhì)異常69個肺段(23.7%);周圍間質(zhì)異常125個肺段(42.9%);間隔間質(zhì)異常97個肺段(33.3%)。伴發(fā)改變:磨玻璃樣影(GGO)48例,實變30例,支氣管播散7例,微結(jié)節(jié)32例,空洞12例,肺大皰18例,氣胸2例。本組病例中經(jīng)規(guī)則抗結(jié)核治療后間質(zhì)病變明顯吸收者31例(31%),稍有吸收者23例(23%),無明顯吸收者46例(46%)。結(jié)論:以肺間質(zhì)改變?yōu)橹鞯姆谓Y(jié)核的HRCT表現(xiàn)具有一定特征性。
[Abstract]:Objective: to investigate the HRCT findings of pulmonary tuberculosis with pulmonary interstitial changes and to improve its imaging diagnosis. Methods: the imaging data of 100 patients with pulmonary tuberculosis were analyzed retrospectively. The HRCT features of these patients were summarized. Results in 100 cases, 361 lung segments were involved. There were 52 cases with right superior lobe apex and posterior segment, 48 cases with left superior apex posterior segment, 53 cases with right inferior lobe basal segment and 51 cases with left inferior lobe basal segment. (predilection and non-predilection) were divided into two groups, A total of 151 lung segments were distributed along the center of lobar segment in the predilection group, 112 lung segments were distributed beside the interlobar pleura (33.3%), significantly more than the 73 lung segments distributed under the pleura (21.775%); in the non-predilection group, 86 lung segments were distributed along the center of the lobar segment, and the interlobar area was 31.5%. Seventy-nine lung segments were distributed around the pleura and 108 under the pleura. The difference between the two groups was statistically significant (蠂 ~ (2) 2) 24.037 (P 0.001). According to the type of interstitial, 69 lung segments were abnormal in axonal stroma, 42.9m in peripheral interstitial abnormalities, and 97 in septal interstitial abnormalities. Accompanied by changes: 48 cases of GGOA with glass-like opacity, There were 30 cases of consolidation, 7 cases of bronchial dissemination, 32 cases of micronodule, 12 cases of cavity, 18 cases of pulmonary bullae. 2 cases of pneumothorax. In this group, 31 cases had obvious absorption of interstitial lesion after regular anti-tuberculosis treatment, 23 cases had slight absorption, 46 cases had no obvious absorption. Conclusion: pulmonary tuberculosis with pulmonary interstitial change is characterized by HRCT.
【作者單位】： 武漢市肺科醫(yī)院放射科;
【分類號】：R521;R816.41
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本文編號：1694972