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肺结核:CT与病理对照

Pulmonary tuberculosis: CT and pathologic correlation.

作者信息

Lee J Y, Lee K S, Jung K J, Han J, Kwon O J, Kim J, Kim T S

机构信息

Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

出版信息

J Comput Assist Tomogr. 2000 Sep-Oct;24(5):691-8. doi: 10.1097/00004728-200009000-00005.

Abstract

Typical CT findings of active postprimary pulmonary tuberculosis include centrilobular nodules and branching linear structures (tree-in-bud appearance), lobular consolidation, cavitation, and bronchial wall thickening. The CT findings of inactive pulmonary tuberculosis include calcified nodules or consolidation, irregular linear opacity, parenchymal bands, and pericicatricial emphysema. The typical appearance of primary tuberculosis on CT scans is homogeneous, dense, well-defined segmental or lobar consolidation with enlargement of lymph nodes in the hilum or the mediastinum. Miliary nodules may be seen in primary and postprimary tuberculosis. On CT, tuberculomas appear as a nodule with surrounding satellite nodules and internal cavitation on CT. Atypical radiologic manifestations of tuberculosis, encountered in as many as one third of the cases of adult-onset tuberculosis, are single or multiple nodules or masses, basilar infiltrates, miliary tuberculosis with diffuse bilateral areas of ground-glass opacity, and reversible multiple cysts. Underlying histopathologic findings of typical and atypical CT findings of tuberculosis are caseating granulomas or pneumonia in the active phase and fibrosis and dystrophic calcification in the inactive phase.

摘要

原发性肺结核活动期的典型CT表现包括小叶中心结节和分支状线性结构(树芽征)、小叶实变、空洞形成以及支气管壁增厚。非活动性肺结核的CT表现包括钙化结节或实变、不规则线性致密影、实质条索影和瘢痕旁肺气肿。原发性肺结核在CT扫描上的典型表现为均匀、致密、边界清晰的节段性或大叶性实变,伴肺门或纵隔淋巴结肿大。粟粒结节可见于原发性和继发性肺结核。在CT上,结核瘤表现为一个结节,周围有卫星结节,内部有空洞。在多达三分之一的成人肺结核病例中会出现非典型的放射学表现,即单个或多个结节或肿块、基底浸润、伴有双侧弥漫性磨玻璃影的粟粒性肺结核以及可逆性多发囊肿。肺结核典型和非典型CT表现的潜在组织病理学发现是活动期的干酪样肉芽肿或肺炎,以及非活动期的纤维化和营养不良性钙化。

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