肺结核的放射学表现

J. Andreu, J. Cáceres, E. Pallisa, M. Martinez-Rodriguez
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引用次数: 8

摘要

肺结核(TP)是世界范围内常见的肺部感染。放射学特征表现出相当大的差异,但在大多数情况下,它们足以提示诊断。传统上,结核病分为常见于儿童期的原发性结核病和常见于成人的原发性结核病。原发性肺结核最典型的影像学表现是淋巴结肿大。增强CT显示肺门和纵隔淋巴结伴中心低密度区提示诊断。空化是原发性肺结核的标志,大约有一半的患者出现空化。在上肺叶的顶端和后段以及下肺叶的上段也常观察到斑片状、不清晰的实变。一些并发症与结核感染有关,如血液播散(军性结核)或延伸到胸膜,导致胸腔积液。结核的晚期并发症包括结核瘤、支气管狭窄、支气管扩张、细支结石、曲霉菌瘤、支气管食管瘘和纤维化性纵隔炎。放射学为这些患者的管理和随访提供了必要的信息,对监测并发症非常有价值。
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Manifestations radiologiques de la tuberculose pulmonaire

Pulmonary tuberculosis (TP) is a common worldwide lung infection. The radiological features show considerable variation, but in most cases they are characteristic enough to suggest the diagnosis. Classically, tuberculosis is divided into primary, common in childhood, and postprimary, usually presenting in adults. The most characteristic radiological feature in primary tuberculosis is lymphadenopathy. On enhanced CT, hilar and mediastinal nodes with a central hypodense area suggest the diagnosis. Cavitation is the hallmark of postprimary tuberculosis and appears in around half of patients. Patchy, poorly defined consolidation in the apical and posterior segments of the upper lobes, and in the superior segment of the lower lobe is also commonly observed. Several complications are associated with tuberculous infection, such as hematogenous dissemination (miliary tuberculosis) or extension to the pleura, resulting in pleural effusion. Late complications of tuberculosis comprise a heterogeneous group of processes including tuberculoma, bronchial stenosis bronchiectasis, broncholithiasis, aspergilloma, bronchoesophageal fistula and fibrosing mediastinitis. Radiology provides essential information for the management and follow-up of these patients and is extremely valuable for monitoring complications.

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