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目的:探讨糖尿病合并肺结核干酪性肺炎的影像学表现特点。方法:18例确诊2型糖尿病合并干酪性肺炎患者,男14例,女4例,年龄47-72岁。临床症状为发热、咳嗽(干咳为主)。均行胸部X线检查及胸部CT扫描。结果:13例表现为大叶性肺炎(72.2%),CT检查发现实变病变中有小空洞存在,5例右下肺可见播散病灶;3例表现为肺不张(16.7%);2例表现为小叶性干酪性肺炎(11.1%)。病变部位:右上肺11例,左上肺4例,右中下肺3例。7例(38.9%)经痰检及纤支镜检查确诊,2例(11.1%)误诊为肺癌,9例(50.0%)在多种治疗无效后1月后确诊。结论:糖尿病合并结核干酪性肺炎主要表现为大叶实变及虫蚀状空洞,一般无肺门及纵隔淋巴结肿大,支气管腔通畅,具有一定特征性,熟悉这些表现特点,对糖尿病合并结核干酪性肺炎影像学诊断有极大帮助。
Objective: To investigate the imaging features of diabetes complicated with tuberculous caseous pneumonia. Methods: 18 cases of type 2 diabetes mellitus complicated with caseous pneumonia were diagnosed. There were 14 males and 4 females, aged 47-72 years old. Clinical symptoms of fever, cough (dry cough-based). All underwent chest X-ray examination and chest CT scan. Results: Lobar pneumonia was found in 13 cases (72.2%). Small CT scans were found in solid lesions, disseminated lesions in 5 cases of right lower lung, and atelectasis in 3 cases (16.7%). Cases showed lobular cheese pneumonia (11.1%). Lesions: 11 cases of right upper lung, 4 cases of left upper quadrant, 3 cases of right middle and lower lung. Seven patients (38.9%) were diagnosed by sputum examination and bronchoscopy. Two patients (11.1%) were misdiagnosed as lung cancer and nine patients (50.0%) were diagnosed after one month after multiple treatments were ineffective. Conclusion: The main clinical manifestations of tuberculous diabetes mellitus complicated with tuberculous meningitis are large-leaved solidification and worm-eaten voids, generally without hilar and mediastinal lymph nodes, with bronchial patency and certain characteristics. They are familiar with these manifestations, Pneumonia imaging diagnosis is of great help.