非结核分枝杆菌肺病的CT表现分析(1)
【摘要】 目的：探讨非结核分枝杆菌肺病CT表现特点及其与肺结核病的鉴别要点。方法：回顾性分析经临床确诊的18例非结核分枝杆菌肺病的CT表现特点。结果：CT上最常见为结节影，本组18例均可见；其次为斑片状影16例、支气管扩张13例、空洞及纤维索条各11例。以上病变均以多种形态混杂共存，多数为两侧多叶散在分布，双肺累及12例，2个肺叶及以上受累16例；上叶比下叶多，上叶受累17例。结论：非结核分枝杆菌肺病的CT主要表现结节影、斑片状影、支气管扩张、空洞及纤维条索，影像表现具备一定特点，但单从影像上和继发型肺结核鉴别困难，多种性质病变同时累及多个肺叶是该病的特点，当出现上述表现或临床规则抗结核治疗疗效欠佳时，应考虑到非结核分支杆菌肺病的可能。
【关键词】 非结核分枝杆菌肺病； CT
中图分类号 R816.41 文献标识码 B 文章编号 1674-6805(2014)12-0060-02
Analysis of CT Manifestations of NTM Pulmonary Disease/WANG Qin-qi，JIANG Yong.//Chinese and Foreign Medical Research，2014，12(12)：60-61
【Abstract】 Objective：To investigate the NTM pulmonary disease CT performance characteristics and in differential diagnosis of pulmonary tuberculosis.Method：To retrospective analysis of the CT features of 18 cases of NTM pulmonary disease patients.Result：Nodule was the most common CT appearance，all were found in 18 cases，secondly were patchy shadow in 16 cases of total，bronchiectasis in 13 cases，empty and fiber cord each in 11 cases.These lesions were in a variety of morphology of the hybrid coexist，the majority of many on both sides of the leaf scattered，12 cases of lung involvement，16 patients had two or more than two lobes of lung involvement，17 cases of patients with upper lobe involvement，upper lobe than the lower lobe involvement.Conclusion：Nodules，patchy shadow，bronchiectasis，empty，fibers of the cable core are the most common non mycobacterium pulmonary disease manifestations of CT，but only from the image and secondary pulmonary，tuberculosis identification is difficult，many properties of lesions and involved multiple lobe is characteristic of the disease，when the above performance or the clinical rule of poor efficacy of anti tuberculosis treatment，consideration should be given to the non tuberculosis mycobacterium tuberculosis may.
【Key words】 NTM pulmonary disease； CT
First-author’s address：Fuqing City Hospital，Fuqing 350300，China
结核分枝杆菌复合群和麻风分支杆菌以外的非结核分枝杆菌(non tuberculous mycobacteria，NTM)引起的疾病称为非结核分枝杆菌病，主要引起肺部病变，亦可侵犯淋巴结、皮肤、软组织和骨骼系统。近年随着检验技术的发展，NTM感染检出率呈增加趋势，NTM肺病和肺结核的临床表现相似，且抗酸杆菌培养均为阳性，临床易将NTM肺病误诊为肺结核而导致治疗迁延，故早期诊断意义重大。现收集2004-2012年经临床确诊的18例NTM肺病的CT图像作一回顾性分析，旨在探讨其CT影像表现特点，为临床诊疗提供参考。
1 资料与方法
1.1 一般资料
本组18例NTM肺病患者均有完整的CT资料，均经过临床及细菌学分离、培养、菌型鉴定而确诊，符合我国关于非结核分枝杆菌肺病的诊断标准[1]。其中男10例，女8例；年龄32～76岁，平均48岁，40岁以上14例。临床主要症状：咳嗽、咳痰12例，咯血丝痰或咯血4例，乏力10例，低热8例，盗汗7例，消瘦2例，胸痛1例。合并糖尿病2例、矽肺1例，本组无合并艾滋病者。
1.2 CT检查方法
使用GE Prospeed FⅡ双螺旋和GE 64排Light speed VCT螺旋CT扫描机，常规自肺尖至肺底螺旋扫描，120 kV，200 mAs，层厚5 mm。13例加HRCT扫描或重建：层厚1.0 mm或0.625 mm，骨算法重建。, 百拇医药(王钦棋 姜勇)
【关键词】 非结核分枝杆菌肺病； CT
中图分类号 R816.41 文献标识码 B 文章编号 1674-6805(2014)12-0060-02
Analysis of CT Manifestations of NTM Pulmonary Disease/WANG Qin-qi，JIANG Yong.//Chinese and Foreign Medical Research，2014，12(12)：60-61
【Abstract】 Objective：To investigate the NTM pulmonary disease CT performance characteristics and in differential diagnosis of pulmonary tuberculosis.Method：To retrospective analysis of the CT features of 18 cases of NTM pulmonary disease patients.Result：Nodule was the most common CT appearance，all were found in 18 cases，secondly were patchy shadow in 16 cases of total，bronchiectasis in 13 cases，empty and fiber cord each in 11 cases.These lesions were in a variety of morphology of the hybrid coexist，the majority of many on both sides of the leaf scattered，12 cases of lung involvement，16 patients had two or more than two lobes of lung involvement，17 cases of patients with upper lobe involvement，upper lobe than the lower lobe involvement.Conclusion：Nodules，patchy shadow，bronchiectasis，empty，fibers of the cable core are the most common non mycobacterium pulmonary disease manifestations of CT，but only from the image and secondary pulmonary，tuberculosis identification is difficult，many properties of lesions and involved multiple lobe is characteristic of the disease，when the above performance or the clinical rule of poor efficacy of anti tuberculosis treatment，consideration should be given to the non tuberculosis mycobacterium tuberculosis may.
【Key words】 NTM pulmonary disease； CT
First-author’s address：Fuqing City Hospital，Fuqing 350300，China
结核分枝杆菌复合群和麻风分支杆菌以外的非结核分枝杆菌(non tuberculous mycobacteria，NTM)引起的疾病称为非结核分枝杆菌病，主要引起肺部病变，亦可侵犯淋巴结、皮肤、软组织和骨骼系统。近年随着检验技术的发展，NTM感染检出率呈增加趋势，NTM肺病和肺结核的临床表现相似，且抗酸杆菌培养均为阳性，临床易将NTM肺病误诊为肺结核而导致治疗迁延，故早期诊断意义重大。现收集2004-2012年经临床确诊的18例NTM肺病的CT图像作一回顾性分析，旨在探讨其CT影像表现特点，为临床诊疗提供参考。
1 资料与方法
1.1 一般资料
本组18例NTM肺病患者均有完整的CT资料，均经过临床及细菌学分离、培养、菌型鉴定而确诊，符合我国关于非结核分枝杆菌肺病的诊断标准[1]。其中男10例，女8例；年龄32～76岁，平均48岁，40岁以上14例。临床主要症状：咳嗽、咳痰12例，咯血丝痰或咯血4例，乏力10例，低热8例，盗汗7例，消瘦2例，胸痛1例。合并糖尿病2例、矽肺1例，本组无合并艾滋病者。
1.2 CT检查方法
使用GE Prospeed FⅡ双螺旋和GE 64排Light speed VCT螺旋CT扫描机，常规自肺尖至肺底螺旋扫描，120 kV，200 mAs，层厚5 mm。13例加HRCT扫描或重建：层厚1.0 mm或0.625 mm，骨算法重建。, 百拇医药(王钦棋 姜勇)