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目的:研究宿主免疫功能低下并发肺结核的CT影像表现特征。方法:搜集38例免疫功能低下并发肺结核患者的临床及CT影像资料,从病变类型、分布、大小、形态、性质以及淋巴结改变等方面进行分析。结果:免疫功能低下并发肺结核患者的CT影像表现以浸润型肺结核为主,病变广泛分布,主要表现为实变阴影(38/38,100%)、多发性结节(21/38,55%)、空洞(16/38,42.1%)、淋巴结改变(11/38,28.9%),多伴有肺气肿、纤维条索硬化、钙化、支气管狭窄或扩张、胸膜改变等征象。结论:宿主免疫功能低下并发肺结核的CT影像学表现复杂多样、多变,发病部位及CT征象均不典型;病变范围广,多性质病灶共存且易扩展播散,肺受损严重、预后差为其特点。CT检查结合病史及临床资料对明确诊断有积极意义。
Objective: To study the features of CT images of pulmonary tuberculosis in immunocompromised patients. Methods: Clinical and CT images of 38 patients with pulmonary tuberculosis complicated with immunocompromised disease were collected and analyzed from the aspects of lesion type, distribution, size, shape, nature and lymph node changes. Results: CT images of tuberculosis patients with immunocompromised pulmonary tuberculosis were mainly infiltrative pulmonary tuberculosis. The lesions were widely distributed, mainly including consolidation shadow (38/38, 100%), multiple nodules (21/38, 55%), (16/38, 42.1%), changes of lymph nodes (11/38, 28.9%), accompanied by emphysema, fibroin sclerosis, calcification, bronchial stenosis or expansion, pleural changes and other signs. Conclusions: CT images of low-grade immunocompromised pulmonary tuberculosis are complex, diverse and changeable, and their locations and CT signs are not typical. A wide range of lesions, multiple lesions coexist and spread easily, lung damage is serious, and the prognosis is poor Its characteristics. CT combined with medical history and clinical data have a positive diagnosis of a clear sense.