摘要
目的分析先天性肺结核患儿的临床及影像学表现，提高对该病的认识水平。方法回顾性分析18例先天性肺结核患儿的临床及影像学资料，其中男性10例，女性8例，年龄17-180天，平均年龄85．5天，18例患儿行X线胸片检查，16例行胸部CT检查，6例行头颅MRI检查。结果临床症状主要为发热咳嗽（18例），实验室检查白细胞增高2例，胃痰液和脑脊液中抗酸杆菌阳性率较低（2／18 vs 0／9），PPD阳性率低（2／18），T-SPOT阳性率较高（3／3）。X线表现为弥漫粟粒结节10例，广泛分布结节一斑片影6例，且分布右肺多于左肺，上肺多于下肺，多伴肺实变（10例），肺门增大（11例）。CT表现中，弥漫粟粒结节9例，结节密度较低，6例伴结节融合，融合结节密度高，边界清；广泛分布结节一斑片影5例，多为类圆形，密度较高，边界可清或伴淡薄样渗出；7例纵隔及肺门淋巴结肿大且伴蛋壳样或沙粒状钙化。6例头颅MRI中，4例有脑皮质或实质病变。结论先天性肺结核的临床表现及结核生化指标检测均缺乏特异性，而影像学表现虽复杂多样，却有一定的规律和特征，能为临床早期诊断及治疗提供帮助。
Objective To study the clinical and imaging features of congenital tuberculosis in infants. Methods The clinical and imaging manifestations of 18 infants with congenital tuberculosis disease were retrospectively analyzed. There were 10 males and 8 females. The age was ranged from 17 to 180 days with mean of 85.5 days. All babies were examined with chest X -ray film,and 16 patients under-went chest CT and 6 patients examined with brain MRI. Results In the clinical presentation, 18 cases presented with fever and cough, white blood cells increased in 2 patients. Acid bacteria positive rate in stomach,sputum and cerebrospinal fluid was low,PPD positive rate was also low. T - SPOT positive rate was high. Chest radiographs showed diffuse miliary nodules in 10 cases ,wide - spread patch - nodular in 6 eases, and there were more nodules in right lung than in the left, more in upper lobe than in lower lobe. Mostly occured with pulmonary consolidation（ 10 cases）,and hilar enlargement of pulmonary（ 11 cases）. In the CT presentations,9 cases showed as diffuse miliary nod- ules ,whose density of nodules were low,and 6 cases with nodules fusion,whose density were high and the edge were ehear. 5 cases showed as wide - spread patch - nodular, mostly were oval,whose density were high and the edge were clear or not. 7 cases with lymph nodes en- larged in hilus and mediastinum. 4 cases with cerebral cortex or parenchyma lesions on MRI. Conclusion The clinical presentation and biochemical criterion detection of congenital tuberculosis were non - specific, though the imaging manifestations were complex and varia- ble. It has certain regulation and characteristic,which is helpful for its diagnosis and theropy.
出处
《医学研究杂志》
2014年第2期127-130,共4页
Journal of Medical Research
关键词
婴儿先天性肺结核
影像学特征
Infant
Congenital tuberculosis
Imaging features
