Andreu J, Cáceres J, Pallisa E, Martinez-Rodriguez M
Department of Radiology, HGU Vall d'Hebron, Universitat Autónoma de Barcelona, Paseo Vall d'Hebron 116, Barcelona 08032, Spain.
Eur J Radiol. 2004 Aug;51(2):139-49. doi: 10.1016/j.ejrad.2004.03.009.
Pulmonary tuberculosis (TB) is a common worldwide lung infection. The radiological features show considerable variation, but in most cases they are characteristic enough to suggest the diagnosis. Classically, tuberculosis is divided into primary, common in childhood, and postprimary, usually presenting in adults. The most characteristic radiological feature in primary tuberculosis is lymphadenopathy. On enhanced CT, hilar and mediastinal nodes with a central hypodense area suggest the diagnosis. Cavitation is the hallmark of postprimary tuberculosis and appears in around half of patients. Patchy, poorly defined consolidation in the apical and posterior segments of the upper lobes, and in the superior segment of the lower lobe is also commonly observed. Several complications are associated with tuberculous infection, such as hematogenous dissemination (miliary tuberculosis) or extension to the pleura, resulting in pleural effusion. Late complications of tuberculosis comprise a heterogeneous group of processes including tuberculoma, bronchial stenosis bronchiectasis, broncholithiasis, aspergilloma, bronchoesophageal fistula and fibrosing mediastinitis. Radiology provides essential information for the management and follow up of these patients and is extremely valuable for monitoring complications.
肺结核是一种全球常见的肺部感染性疾病。其影像学表现差异较大,但在大多数情况下具有足够的特征性以提示诊断。传统上,结核病分为原发性(常见于儿童)和继发性(通常见于成人)。原发性肺结核最具特征性的影像学表现是淋巴结肿大。增强CT上,肺门和纵隔淋巴结出现中央低密度区提示诊断。空洞形成是继发性肺结核的标志,约半数患者会出现。上叶尖段和后段以及下叶背段的斑片状、边界不清的实变影也较为常见。结核感染会引发多种并发症,如血行播散(粟粒性肺结核)或累及胸膜导致胸腔积液。结核病的晚期并发症包括一组异质性病变,如结核瘤、支气管狭窄、支气管扩张、支气管结石、曲菌球、支气管食管瘘和纤维性纵隔炎。放射学检查为这些患者的管理和随访提供重要信息,对于监测并发症也极具价值。