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目的通过对102例不典型肺结核患者的胸部CT影像学特征及临床资料的回顾性分析,提高对不典型肺结核诊断的准确率。方法回顾性分析2012年1月至2013年6月102例不典型结核患者的胸部CT影像表现、临床症状及诊断方法。结果 102例患者中表现为肺炎实变型48例(47.1%)、孤立结节或肿块型17例(16.7%)、多发结节型16例(15.7%)、间质改变型21例(20.6%);经痰涂片抗酸染色阳性而诊断79例(77.5%);经支气管镜获得组织病理检查诊断10例(9.8%);经CT引导下肺穿刺活检诊断13例(12.7%);经手术取得组织病理诊断14例(13.7%)。结论不典型肺结核的影像表现多样,需综合各种检查结果,同时结合临床特征及实验室检查等做出诊断。
Objective To retrospectively analyze the chest CT features and clinical data of 102 patients with atypical pulmonary tuberculosis to improve the diagnostic accuracy of atypical pulmonary tuberculosis. Methods A retrospective analysis of 102 patients with atypical tuberculosis from January 2012 to June 2013 was performed on chest CT images, clinical symptoms and diagnostic methods. Results Forty-eight patients (47.1%) had pneumonia consolidation, 17 (16.7%) had solitary nodules or masses, 16 (15.7%) had multiple nodules and 21 (20.6% ); Sputum smear positive acid-fast staining was diagnosed in 79 cases (77.5%); bronchoscopy was diagnosed by histopathology in 10 cases (9.8%); CT guided lung biopsy in 13 cases (12.7%); Histopathological diagnosis of surgery to obtain 14 cases (13.7%). Conclusions The images of atypical pulmonary tuberculosis are diverse, and the results of various examinations need to be combined with the clinical features and laboratory tests.