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目的探讨不典型肺结核的影像学特点,以提高诊断及鉴别诊断水平。方法收集61例不典型肺结核患者的临床资料,分析其影像学特征。结果 61例首次诊断均不能确定,其中26例按一般肺部炎症治疗2周后未见好转,改行抗结核治疗后有效而确诊为肺结核;19例经纤支镜活检病理证实为肺结核;9例经肺穿刺活检病理证实,7例痰结核菌阳性而确诊。所有病例均经正规抗结核治疗后痊愈或病情趋于稳定。影像学表现:肺叶、肺段实变或肺不张26例,结节及肿块阴影23例,肺门及纵隔淋巴结增大12例。结论不典型肺结核影像学表现多种多样,应充分运用多种检测手段进行综合分析,结合临床做好鉴别诊断。
Objective To investigate the imaging features of atypical pulmonary tuberculosis to improve the diagnostic and differential diagnosis. Methods The clinical data of 61 patients with atypical pulmonary tuberculosis were collected and their imaging features were analyzed. Results 61 cases of the first diagnosis can not be determined, of which 26 cases of general lung inflammation after 2 weeks of treatment did not improve, diverted to anti-TB treatment and effective diagnosis of pulmonary tuberculosis; 19 cases of bronchoscopic biopsy confirmed pulmonary tuberculosis; 9 cases Pulmonary biopsy biopsy confirmed that 7 cases of sputum positive for TB confirmed. All cases were cured after regular anti-TB treatment or the disease tended to be stable. Imaging findings: pulmonary lobe, pulmonary segment consolidation or atelectasis in 26 cases, nodules and mass shadow in 23 cases, hilar and mediastinal lymph nodes increased in 12 cases. Conclusions The manifestations of atypical pulmonary tuberculosis are various and should be fully analyzed by a variety of detection methods, and combined with clinical diagnosis.