Wormanns D
Radiologisches Institut, Evangelische Lungenklinik Berlin, 13125, Berlin, Deutschland.
Radiologe. 2012 Feb;52(2):173-84. doi: 10.1007/s00117-011-2263-2.
Pulmonary tuberculosis is now gaining increasing importance after decades of retreat. Radiological imaging plays an important role in the initial diagnosis but cannot replace bacteriological confirmation of the diagnosis. Primary tuberculosis usually presents as a primary complex consisting of a pulmonary infiltrate and hilar lymphadenopathy. Pleural effusion may be the only sign of primary tuberculosis. Typical manifestation depends on patient age: adults most commonly present with pulmonary consolidation, whereas in children lymphadenopathy is the most common finding. This can cause bronchial obstruction with atelectasis or hyperinflation. The spectrum of secondary manifestations is presented. Long-lasting hematogenous, lymphogenous, endobronchial and local spread of the disease results in a highly variable mixture of radiological appearances.
在经历了数十年的消退后,肺结核如今正变得日益重要。放射影像学在初始诊断中发挥着重要作用,但无法取代诊断的细菌学确认。原发性肺结核通常表现为一个由肺部浸润和肺门淋巴结肿大组成的原发综合征。胸腔积液可能是原发性肺结核的唯一征象。典型表现取决于患者年龄:成人最常见的表现是肺部实变,而在儿童中淋巴结肿大是最常见的发现。这可导致支气管阻塞伴肺不张或肺过度充气。文中展示了继发性表现的范围。疾病长期的血行、淋巴、支气管内和局部播散导致了放射学表现的高度可变组合。