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目的:分析气管支气管结核的多层CT(MSCT)表现,并探讨其诊断价值。材料和方法:回顾性分析38例(男12例,女26例,年龄14～53岁,中位数33岁)气管支气管结核,23例经组织学证实,15例经痰菌检查结合多种其他方法临床证实。MSCT检查采用5mm、2.5mm或1mm准直螺旋扫描,结合2.5mm或1mm的薄层扫描,22例做了增强扫描,全部病例均完成了至少2种后处理;32例同期完成了纤维支气管镜检查。5例瘢痕狭窄行支架治疗,治疗前后均行CT检查。结果:38例共检出58支病变,多支受累率44.7％(17/38);支气管狭窄44例,狭窄长度2cm以上93.2％(41/44);管壁不规则增厚,有时见腔内结节;多数(35/38)伴肺内结核病灶;可伴肺门纵隔淋巴结肿大。MSCT结合各种后处理技术可以有效显示病变特征,并特别有助于支架治疗前后气道通畅性的判断。结论:MSCT结合后处理技术可以有效显示气管支气管结核的特征,有助于诊断,并特别有助于支架治疗前后气道狭窄的判断。
Objective: To analyze the multi-slice CT (MSCT) manifestations of tracheobronchial tuberculosis and to explore its diagnostic value. Materials and Methods: A retrospective analysis of 38 cases (12 males and 26 females, aged 14-53 years, median 33 years old) tracheobronchial tuberculosis, 23 cases confirmed by histology, 15 cases of sputum bacteria combined with a variety of Other methods are clinically confirmed. MSCT was performed with a 5mm, 2.5mm or 1mm collimation helical scan combined with a 2.5mm or 1mm thin-layer scan and an enhanced scan of 22 patients with at least 2 post-treatments completed in all cases; 32 patients completed bronchoscopy an examination. Five cases of stenosis scaffolds were treated with CT examination before and after treatment. Results: A total of 58 lesions were detected in 38 cases, with 44.7% (17/38) in multiple branches, 44 in bronchial stenosis and 93.2% (41/44) in stenosis more than 2 cm. Irregular wall thickening was found in the cavity Nodules; most (35/38) with pulmonary tuberculosis; may be associated with hilar mediastinal lymph nodes. MSCT combined with a variety of post-treatment techniques can effectively display the characteristics of the lesion, and in particular, to help determine the airway patency before and after stent treatment. Conclusion: MSCT combined with post-processing technique can effectively display the characteristics of tracheobronchial tuberculosis, which is helpful for diagnosis and is especially helpful for the judgment of airway stenosis before and after stent treatment.