Moon W K, Han M H, Chang K H, Kim H J, Im J G, Yeon K M, Han M C
Department of Radiology, Seoul National University College of Medicine, South Korea.
AJR Am J Roentgenol. 1996 Feb;166(2):445-9. doi: 10.2214/ajr.166.2.8553964.
The purpose of this study was to evaluate the CT findings of laryngeal tuberculosis (TB).
CT scans, laryngoscopic examinations, and chest radiographs of 12 patients (21-63 years old) with histologically (n = 8) or bacteriologically (n = 4) confirmed laryngeal TB were retrospectively reviewed.
Bilateral diffuse thickening of the vocal cords and diffuse thickening and increased density of the aryepiglottic folds and paralaryngeal tissues were present in all patients. Diffuse thickening of the epiglottis was observed in seven patients. In four patients, a focal mass was noted in the anterior portions of the vocal cords (n = 3) or tip of the epiglottis (n =1). Destruction or sclerosis of cartilage was not found. Subglottic extension of the lesion was suspected in only one patient. Enlarged cervical lymph nodes were found in five patients. On laryngoscopic examinations, swelling of the vocal cords (n = 12) or epiglottis (n = 6) was present in all patients and was bilateral in nine patients. Vocal cord mobility was impaired in only one patient. Radiographic findings consistent with active pulmonary TB were present in all patients.
Although the CT appearances of laryngeal TB are not specific, the possibility of laryngeal TB should be raised when bilateral and diffuse laryngeal lesions are encountered without destruction of the laryngeal architecture in patients with pulmonary TB.
本研究旨在评估喉结核的CT表现。
回顾性分析12例(年龄21 - 63岁)经组织学(n = 8)或细菌学(n = 4)确诊的喉结核患者的CT扫描、喉镜检查及胸部X线片。
所有患者均出现双侧声带弥漫性增厚,杓会厌襞及喉旁组织弥漫性增厚且密度增加。7例患者观察到会厌弥漫性增厚。4例患者在声带前部(n = 3)或会厌尖端(n = 1)发现局灶性肿块。未发现软骨破坏或硬化。仅1例患者怀疑病变有声门下扩展。5例患者发现颈部淋巴结肿大。喉镜检查显示,所有患者均出现声带(n = 12)或会厌(n = 6)肿胀,其中9例为双侧肿胀。仅1例患者声带活动受限。所有患者胸部X线表现均符合活动性肺结核。
虽然喉结核的CT表现不具有特异性,但肺结核患者出现双侧弥漫性喉部病变且无喉结构破坏时,应考虑喉结核的可能性。