摘要
目的探讨艾滋病（AIDS）并发肺结核肺内播散的影像特点。方法回顾性分析经临床及实验室检查证实的33例AIDS并发肺结核肺内播散的x线胸片及MSCT影像资料，总结其影像表现特征。结果首诊x线胸片检查30例，29例表现异常，包括病灶呈双侧播散性分布21例，单侧多发病变8例。所有患者均行MSCT扫描，病变呈单侧和双侧肺内多发分布分别为7例和26例；病变形态包括结节（25例）、粟粒（22例）、气腔实变（22例）、空洞（11例）、纤维索条（7例）、磨玻璃影（7例）、肺气囊（4例）、钙化（2例）。肺内病变形态包含3种以上表现者20例，1种和2种表现者13例。33例患者的肺外结核包括胸膜受侵33例，淋巴结受累30例，肠结核3例，肾结核2例，脾结核1例，结核性脑膜炎1例。结论AIDS患者肺内出现累及多叶、多段的弥漫性结节、粟粒、气腔实变或多发空洞，同时伴淋巴结受累、胸膜浸润，应高度提示播散性肺结核感染。
Objective To study the imaging findings of disseminated pulmonary tuberculosis in patients with acquired immunodeficiency syndrome （AIDS）. Methods X-ray and multi-slice CT （MSCT） data from 33 AIDS patients with disseminated pulmonary tuberculosis confirmed by clinical manifestations and laboratory tests were analyzed retrospectively. Results Thirty patients underwent initial chest radiography examination, 29 patients showed abnormal appearances, including bilateral disseminations in 21 patients and unilateral multiple disseminations in 8 patients. All patients underwent MSCT examination, 26 patients showed bilateral disseminations and 7 patients showed unilateral multiple disseminations. The abnormal pulmonary appearances included nodule （ n = 25 ） , miliary nodule （ n = 22 ） , air-space consolidation （ n = 22 ） , cavity （ n = 11 ） , fibrosis （ n = 7 ） , ground-glass opacity （ n = 7 ） , pneumatocele （ n = 4 ） , calcification （n = 2 ）. There were 20 patients with more than 3 abnormal appearances and 13 patients with one or two abnormal appearances. The extra-pulmonary tuberculosis included pleural effusion （ n = 33 ）, lymphadenopathy （ n = 30 ）, intestinal tuberculosis （ n = 3 ）, splenic tuberculosis （ n = 1 ） and cerebral tuberculosis （n = 1 ）. Conclusion Disseminated puhnonary tuberculosis should be highly suspected in AIDS patients with diffused nodules, miliary nodules, air-space consolidations or muhiple cavities, accompanied with pleural effusion and lymphadenopatby.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2013年第1期13-17,共5页
Chinese Journal of Radiology
关键词
结核
肺
获得性免疫缺陷综合征
体层摄影术
X线计算机
Tuberculosis, Pulmonary
Acquired Immunodeficiency Syndrome
Tomography,X-ray computed
