中国实用儿科杂志

中国实用儿科杂志 ›› 2013, Vol. 28 ›› Issue (03): 214-218.

• 论著 • 上一篇    下一篇

婴幼儿肺结核多层螺旋CT表现特征研究

  

  1. 1.广州市胸科医院放射科，广东  广州  510095；2.中山大学附属第一医院放射科，广东  广州  510080
  • 出版日期:2013-03-06 发布日期:2013-03-28

Characteristics of MSCT manifestation of infants and young children with intra-thoracic tuberculosis.              

  1. Department of Radiology， Guangzhou Chest Hospital， Guangzhou 510095， China
  • Online:2013-03-06 Published:2013-03-28

摘要：

目的    探讨和分析婴幼儿肺结核的多层螺旋CT影像学（MSCT）表现特点。方法    回顾性分析广州市胸科医院2010年1月至2012年6月收治的76例胸内结核婴幼儿胸部MSCT影像资料，对其特点进行分析总结，并对肺内病灶进行分类。结果    76例中，男女之比为48∶28。粟粒型肺结核有7例，合并空洞6例，合并结核性脑膜炎15例。6例无肺内浸润灶；单肺叶受累18例；4个或4个以上肺叶受累31例，其中右上肺受累48例，右中肺43例，右下肺53例，左上肺36例，左下肺40例。根据CT特征将肺内病灶分为5种类型：（1）结节型：肺内病灶主要表现为结节者，共16例；（2）炎症型：肺内病灶为磨玻璃影、斑片、条索和（或）实变者，共24例；（3）肿块型：肺内病灶以团块为主者，共19例；（4）粟粒型：共7例；（5）支气管内膜结核型：4例。共71例病例合并肺门纵隔淋巴结肿大，主要分布在2R（75.00%）、4R（76.32%）、5区（57.89%）、7区（76.32%）、8区（68.42%）及10R（75.00%）、11R（64.47%）。肿大淋巴结平扫以中等密度为主，内出现钙化有40例。出现腋窝淋巴结肿大39例。合并左侧胸膜炎8例，合并右侧胸膜炎9例。结论    婴幼儿肺结核以肺内病灶并肺门纵隔淋巴结肿大为主要表现，但多数肺内病灶形态与原发综合征不同，肺门及纵隔、腋窝淋巴结肿大及淋巴结钙化常见，内膜结核、胸膜炎及空洞的发生率不高。

Abstract:

Objective    To investigate and analyze the characteristics of MSCT manifestation of infants and young children with intra-thoracic tuberculosis. Methods    A retrospective analysis of MSCT chest performances of 76 cases of infants and young children （ages 0-3 years）with intrathoracic tuberculosis from January 2010 to June 2012 in our hospital was done to find the characteristics and classify pulmonary lesions of it. Results    In this study， the male to female ratio was 48:28； 7 cases were miliary tuberculosis， 6 cases were with cavitates， 15 cases with tuberculous meningitis. 6 cases had no pulmonary lesions， 18 cases only had single lobe involved，and 31 cases had four or more than four lobes involved；among all the cases， the right upper lobe was involved in 48 cases， right middle lobe 43 cases， right lower lobe 53 cases， left upper lobe 36 cases， left lower lobe 40 cases. We classified cases of pulmonary lesions into five types based on the CT features: （1） nodular type: pulmonary lesions were mainly nodular， a total of 16 cases； （2） inflammatory type: pulmonary lesions were ground-glass opacities， patches， cords and （or） consolidation， 24 cases； （3） mass type: pulmonary lesions were mainly clumps， 19 cases； （4） military type: 7 cases； （5） endobronchial tuberculosis type: 4 cases.Totally 71 cases of hilar and mediastinal adenopathy were found， and mainly in 2R （75.00%）， 4R （76.32%）， district 5 （57.89%）， district 7 （76.32%）， 8 （68.42%） and 10R （75.00%）， 11R （64.47%）. Most of the swollen lymph nodes in plain CT scan were medium-density， and calcification was found in 40 cases. Totally 39 cases had enlarged axillary lymph nodes. There were 8 cases with left pleurisy， 9 cases with right pleurisy. Conclusion    The main MSCT manifestation of infants and young children with intra-thoracic tuberculosis is pulmonary lesions with hilar and mediastinal adenopathy， but the majority of pulmonary lesions of them on CT are different with primary complex， hilar and mediastinal adenopathy、enlarged axillary lymph nodes and lymph nodes with calcification are common，while endobronchial tuberculosis，pleurisy and cavitas are rare.