成人不典型肺结核58例影像表现及误诊分析-海南医学.PDF

HAINAN MEDICAL JOURNAL 《海南医学》2012 年第23 卷第16 期 doi:10.3969/j.issn.1003-6350.2012.16.042 ·医技与临床· 成人不典型肺结核58 例影像表现及误诊分析 * 蔡亲磊，陈 洋，郭珊熹 （海南省人民医院放射科，海南 海口 570311） 【摘要】 目的 探讨不典型肺结核影像学特点，以便与其他肿块性病变特别是周围型肺癌鉴别。方法 回 顾性分析58 例均经手术和/或病理组织学证实的不典型肺结核的X 线和CT 影像学表现及误诊情况。结果 根 据CT 征象，将58 例不典型肺结核分为结节或肿块型31 例（53.4%），节段或肺叶实变型12例（20.7% ），空洞型6 例 （10.3%），支气管内膜结核、肺底结核及粟粒结节型各3 例（5.2%）。不典型肺结核首诊误诊率26 例，占44.83% ，其 中15例被误诊为肺癌，超过一半。结论 不典型肺结核主要误诊原因是过分依赖影像学征象的诊断价值；对各 种影像征象进行综合分析，并对病灶进行动态观察有助于提高不典型肺结核的诊断率。 【关键词】 肺结核；影像学诊断；误诊 【中图分类号】R521 【文献标识码】A 【文章编号】 1003—6350（2012 ）16—097—04 Imaging manifestation and misdiagnosis analysis of 58 cases of adult atypical pulmonary tuberculosis. CAI * Qin-lei,CHENYang ,GUOShan-xi.DepartmentofRadiology,PeoplesHospitalofHainanProvince,Haikou570311, Hainan,CHINA 【Abstract 】 Objective To investigate the imaging features of atypical pulmonary tuberculosis, and to identify peripheral lung cancer from other mass lesions Methods The X-ray and CT imaging manifestations and misdiagno- sis of 58 cases of atypical pulmonary tuberculosis were analyzed retrospectively. All the cases were confirmed by oper- ation and or pathology. Results The clinical symptoms, X-ray and CT imaging manifestations of atypical pulmonary tuberculosis were non-specific, with the positive rate for tuberculosis bacteria of 10.3%. X-ray could only detect some abnormal shadow in lung, while CT could show certain characteristic signs. According to CT manifestations, the 58 cases of tuberculosis were divided into 31