Miller W T, MacGregor R R
AJR Am J Roentgenol. 1978 May;130(5):867-75. doi: 10.2214/ajr.130.5.867.
The changing pattern of the radiologic presentation of tuberculosis was noted in a review of 100 consecutive cases of pulmonary tuberculosis. Active tuberculosis was not suggested as a radiologic diagnosis in 43% of the patients. Of the 100 cases, only 66 had characteristics of reactivation tuberculosis (i.e., minimal upper lobe infiltrate or more advanced cavitary disease). Of the other 34 patients, 18 had less usual presentations, making the radiographic diagnosis difficult. The remaining 16 patients had radiographic patterns quite unusual for tuberculosis, including masslike densities resembling carcinoma; chronic infiltrates in a lower lobe; miliary tuberculosis, either superimposed on diffuse interstitial lung disease or associated with a diffuse lung pattern atypical for miliary disease; and normal chest radiograph.
在对100例连续性肺结核病例的回顾中,注意到了肺结核放射学表现的变化模式。43%的患者放射学诊断未提示活动性肺结核。在这100例病例中,只有66例具有复发性肺结核的特征(即上叶轻微浸润或更严重的空洞性病变)。在其他34例患者中,18例表现不常见,使得放射学诊断困难。其余16例患者的放射学表现对于肺结核来说非常不寻常,包括类似癌的块状密度影;下叶慢性浸润;粟粒性肺结核,要么叠加在弥漫性间质性肺病上,要么与不典型的弥漫性粟粒性肺病相关;以及胸部X线片正常。