CAJ | 학술논문

目的探讨艾滋病(AIDS)并发肺结核肺内播散的影像特点.方法回顾性分析经临床及实验室检查证实的33例AIDS并发肺结核肺内播散的X线胸片及MSCT影像资料,总结其影像表现特征.结果首诊X线胸片检查30例,29例表现异常,包括病灶呈双侧播散性分布21例,单侧多发病变8例.所有患者均行MSCT扫描,病变呈单侧和双侧肺内多发分布分别为7例和26例；病变形态包括结节(25例)、粟粒(22例)、气腔实变(22例)、空洞(11例)、纤维索条(7例)、磨玻璃影(7例)、肺气囊(4例)、钙化(2例).肺内病变形态包含3种以上表现者20例,1种和2种表现者13例.33例患者的肺外结核包括胸膜受侵33例,淋巴结受累30例,肠结核3例,肾结核2例,脾结核1例,结核性脑膜炎1例.结论 AIDS患者肺内出现累及多叶、多段的弥漫性结节、粟粒、气腔实变或多发空洞,同时伴淋巴结受累、胸膜浸润,应高度提示播散性肺结核感染.
목적 탐토애자병(AIDS)병발폐결핵폐내파산적영상특점.방법 회고성분석경림상급실험실검사증실적33례AIDS병발폐결핵폐내파산적X선흉편급MSCT영상자료,총결기영상표현특정.결과 수진X선흉편검사30례,29례표현이상,포괄병조정쌍측파산성분포21례,단측다발병변8례.소유환자균행MSCT소묘,병변정단측화쌍측폐내다발분포분별위7례화26례；병변형태포괄결절(25례)、속립(22례)、기강실변(22례)、공동(11례)、섬유색조(7례)、마파리영(7례)、폐기낭(4례)、개화(2례).폐내병변형태포함3충이상표현자20례,1충화2충표현자13례.33례환자적폐외결핵포괄흉막수침33례,림파결수루30례,장결핵3례,신결핵2례,비결핵1례,결핵성뇌막염1례.결론 AIDS환자폐내출현루급다협、다단적미만성결절、속립、기강실변혹다발공동,동시반림파결수루、흉막침윤,응고도제시파산성폐결핵감염.
Objective To study the imaging findings of disseminated pulmonary tuberculosis in patients with acquired immunodeficiency syndrome (AIDS).Methods X-ray and multi-slice CT (MSCT)data from 33 AIDS patients with disseminated pulnonary tuberculosis confirmed by clinical manifestations and laboratory tests were analyzed retrospectively.Results Thirty patients underwent initial chest radiography examination,29 patients showed abnormal appearances,including bilateral disseminations in 21 patients and unilateral multiple disseminations in 8 patients.All patients underwent MSCT examination,26 patients showed bilateral disseminations and 7 patients showed unilateral multiple disseminations.The abnormal pulmonary appearances included nodule (n =25),miliary nodule (n =22),air-space consolidation (n =22),cavity (n =11),fibrosis (n =7),ground-glass opacity (n =7),pneumatocele (n =4),calcification (n =2).There were 20 patients with more than 3 abnormal appearances and 13 patients with one or two abnormal appearances.The extra-pulmonary tuberculosis included pleural effusion (n =33),lymphadenopathy (n =30),intestinal tuberculosis (n =3),splenic tuberculosis (n =1) and cerebral tuberculosis (n =1).Conclusion Disseminated pulmonary tuberculosis should be highly suspected in AIDS patients with diffused nodules,miliary nodules,air-space consolidations or multiple cavities,accompanied with pleural effusion and lymphadenopathy.