新发传染病电子杂志2025，Vol.10Issue(4)：19-26,8.DOI:10.19871/j.cnki.xfcrbzz.2025.04.004
不典型活动性肺结核的多层螺旋CT表现及临床特征分析
Analysis of MSCT manifestation and clinical features of atypical active pulmonary tuberculosis
摘要
Abstract
Objective To analyze MSCT features and clinical characteristics of atypical active pulmonary tuberculosis,to improve the understanding of atypical active pulmonary tuberculosis and to provide an imaging basis for clinical treatment.Method A total of 138 patients with atypical active pulmonary tuberculosis,150 cases with typical secondary pulmonary tuberculosis(typical secondary group)and 41 cases with typical hematogenous disseminated pulmonary tuberculosis(typical hematogenous group)from January 2018 to June 2024 were collected at Guangzhou Chest Hospital.The CT image features and clinical features of different types of atypical pulmonary tuberculosis were compared and analyzed with the corresponding typical groups,and the imaging and clinical features of each type of atypical pulmonary tuberculosis were summarized.Result According to CT findings,138 cases of atypical pulmonary tuberculosis were divided into interstitial type(48 cases),mass type(24 cases),multiple nodule type(46 cases),multiple cystic type(11 cases)and consolidation type(9 cases)."Fireworks sign"was showed in interstitial type,the clinical symptoms were mild,and the bacterial negative rate was higher in interstitial type than that of typical secondary group(P＜0.05).In the patients with mass type,the rate of multiple pulmonary masses was higher than that of single mass,the rate of lesions in both upper lobes was lower than that in the typical secondary group,and the rate of calcification,delayed prognosis and age of onset was significantly higher than that of typical group(P＜0.05).Type of multiple cystic variants was characterized by multiple pulmonary air sacs distributed along the bronchial tract,64%(7/11)of which were complicated by ground-glass-opacity,and the ratio of delayed prognosis and poor prognosis in this group was significantly higher than that in typical secondary group(P＜0.05).Random distribution of nodules in both lungs were showed in type of multiple nodules,which were larger than miliary nodules,and the rate of cases combined with other systemic tuberculosis was higher than that in Typical hematogenous group(P＜0.05).The results showed that the incidence of lesions in the right middle lung in consolidation type was higher than that of typical secondary group,33%(3/9)of which were combined with ground-glass-opacity,and the rate of delayed prognosis and poor prognosis in consolidation type was significally higher than that in the typical secondary group(P＜0.05).Except for the interstitial type,the rate of combined underlying diseases in other types of atypical pulmonary tuberculosis was higher than that in the corresponding typical group(P＜0.05).Conclusion The CT manifestations and distribution of most atypical pulmonary tuberculosis are highly specific,with high rates of underlying diseases and delayed prognosis.关键词
不典型肺结核/计算机断层扫描/烟花征/肿块/多发囊样变/多发结节/肺实变Key words
Atypical pulmonary tuberculosis/Computed tomography/Fireworks sign/Mass/Multiple cystic lesions/Multiple nodules/Lung consolidation分类
医药卫生引用本文复制引用
宋敏,方伟军,韩远远,梁瑞云..不典型活动性肺结核的多层螺旋CT表现及临床特征分析[J].新发传染病电子杂志,2025,10(4):19-26,8.基金项目
1.北京医学奖励基金会课题(YXJL-2024-0350-0245) （YXJL-2024-0350-0245）
2.广州市基础研究计划市校(院)企联合资助项目(2023A03J0536) （院）
3.广州市科技计划项目(2025A03J3606) （2025A03J3606）
