摘要
目的观察肺结核空洞性病变的发生及其临床、影像学表现,探讨其发病和病理演变机制的变化与特征。资料与方法搜集本院161例空洞性肺结核患者的临床和CT检查资料。分析各类空洞病变的发生率、形态特征及其与发病年龄、发病时间、伴随征象和细菌学检查结果等临床因素的关系。结果161例中厚壁空洞133例(82.6%)、薄壁空洞13例(8.1%)、无壁空洞15例(9.3%)。120例为新发病例。患者从出现症状到CT检查的时间间隔为4h～317天,将120例新发病例分为急性、亚急性和慢性发病组。无壁空洞全部分布于急性和亚急性组,薄壁空洞仅见于急性组,厚壁空洞在各组均有分布。三种类型空洞在各组间的分布差异有统计学意义(P<0.05)。127例空洞伴有"树芽征"(78.9%),三种空洞伴发"树芽征"的比率差异有统计学意义(P<0.05)。结论肺结核空洞性病变发病率增高且越来越多地产生于肺实变基础上的迅速坏死,其发生方式和影像学变化反映了现代肺结核的发病及其病理演变的新特征。
Objective To analyse the clinical and CT appearance of pulmonary tuberculosis cavity. Materials and Methods 161 patients with pulmonary tuberculosis cavitary confirmed by pathological or clinical data were reviewed. The cavity lesions were divided into three types,included no wall,thick-walled,and thin-walled cavity. The incidence and morphological features of each type were analyzed. The relationship between the patterns of lesion and the clinical factors such as complication,symptom and the bacteriological examination were also investigated. Results There were 15 cases（9.3%）of no wall cavities,133 cases（82.6%）of thick-walled cavities and 13 cases（8.1%）of thin-walled cavities. The interval times from symptoms present to CT examination were 4 h-317 days. 120 of 161patients were new cases and were divided into acute,subacute and chronic group respectively. The cases of no wall cavity distributed mainly in acute group（10,76.9%） and subacute group （3,23.1%）. The cases of thin-walled cavity were distributed only in acute group. The cases of thick-walled cavity distributed in all groups. There were significant differences for three types of cavity among each group（P0.05）. The distribution ＂tree-in-bud＂ pattern were observed in 127 cases （78.9%）. 56 of 161 cases （34.7%） were positive in sputum examination of acid-fast bacilli. Conclusion The incidence rate of pulmonary tuberculosis cavity is increasing. More and more of the cavities arise from rapidly necrosis based on pulmonary consolidation. The features of cavity has changed obviously,which indicate contemporary pulmonary tuberculosis have varied in Pathogenesis and pathological evolution.
出处
《临床放射学杂志》
CSCD
北大核心
2010年第5期603-606,共4页
Journal of Clinical Radiology
基金
珠海市卫生局医学科研基金资助项目(2007052)
