| 孟祥,高剑波,赵青霞,孙燕,杨学华,张岩,周志刚,郭华,岳松伟,丁昌懋.艾滋病合并肺结核的影像学研究[J].中国医学影像技术,2008,24(6):900~904 |
| 艾滋病合并肺结核的影像学研究 |
| Study on imaging findings of AIDS with pulmonary tuberculosis |
| 投稿时间：2007-07-13 修订日期：2008-03-13 |
| DOI： |
| 中文关键词: 获得性免疫缺陷病 结核,肺 诊断影像学 |
| 英文关键词:Acquired immunodeficiency syndrome Tuberculosis, pulmonary Diagnostic imaging |
| 基金项目:本研究受河南省卫生厅科技攻关项目计划(2004-13-02)资助。 |
| 作者 | 单位 | E-mail | | 孟祥 | 商丘市中心医院影像科,河南 商丘 476000 | | | 高剑波 | 郑州大学第一附属医院放射科,河南 郑州 450052 | cjr.gaojianbo@vip.163.com | | 赵青霞 | 郑州市第六人民医院内科,河南 郑州 450052 | | | 孙燕 | 郑州市第六人民医院内科,河南 郑州 450052 | | | 杨学华 | 郑州大学第一附属医院放射科,河南 郑州 450052 | | | 张岩 | 郑州大学第一附属医院放射科,河南 郑州 450052 | | | 周志刚 | 郑州大学第一附属医院放射科,河南 郑州 450052 | | | 郭华 | 郑州大学第一附属医院放射科,河南 郑州 450052 | | | 岳松伟 | 郑州大学第一附属医院放射科,河南 郑州 450052 | | | 丁昌懋 | 郑州大学第一附属医院放射科,河南 郑州 450052 | |
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| 中文摘要: |
| 目的 对比艾滋病(AIDS)合并肺结核与单纯肺结核病人的影像学差异,探讨AIDS合并肺结核的影像学特征。方法 对45例AIDS合并肺结核病人进行影像学检查,其中胸部平片及CT检查7例,单纯CT检查38例,其中8例加做高分辨率CT(HRCT)扫描,4例加做增强扫描。单纯肺结核50例病人均有CT扫描。对合并肿块或纵隔可疑淋巴结结核病人行增强扫描。扫描结果根据发病部位、范围及病变性质进行对比分析。结果 病变部位及范围对比:病变累及双肺、病变累及两叶和两叶以上、病变仅累及肺基底部或(和)前部(舌叶、中叶、上叶前段)组间的出现率之间的差异具有统计学意义(P＜0.05)。病变性质特点对比:斑片状或大片状实变阴影、多发结节影、胸内淋巴结结核、胸腔积液出现率组间的差异具有统计学意义(P＜0.05)。大片实变影内多发空洞出现率两者差异有统计学意义(χ2＝4.222,P＝0.040)。两组患者年龄及CD4 T细胞数检测结果对比:年龄比较差异无统计学意义(t=1.797,P＝0.076);45例AIDS合并肺结核患者CD4 T细胞中位数为41/mm3,30例单纯肺结核患者CD4 T细胞中位数为244/mm3,二者比较差异有统计学意义(u=107.000, P＜0.001)。结论 AIDS合并肺结核的胸部X线影像学表现由于CD4 T细胞数减少而不典型。AIDS病人胸部呈多肺叶浸润,不典型部位(肺基底部或前部)亦常被侵犯,多发斑片或大片状实变阴影、多发结节性病变、纵隔淋巴结肿大、大片实变影内多发小空洞发生率明显增高,且常常是多种不典型征象并存。 |
| 英文摘要: |
| Objective To observe the imaging features of pulmonary tuberculosis with AIDS and the difference from pulmonary tuberculosis without AIDS. Methods Among 45 AIDS patients with pulmonary tuberculosis, 7 cases underwent CT scan and chest plain films, 38 cases underwent CT scan (8 cases with HRCT scan and 4 cases with contrast-enhanced scan additionally). Fifty non-AIDS patients with pulmonary tuberculosis underwent CT scan. The contrast-enhanced scan was performed when the mass or mediastinal adenopathy was defined. A retrospective contrast analysis was carried out according to the location and character of imaging findings. Results "The location and range of lesions": distributed in two lungs, more than two lobes, only in the bases and (or) the anterior segment of the lung had significant difference between two groups (P＜0.05). "Characteristics": patchy and larger confuent consolidation, multiple nodular opacities, pleural effusion and large confuent consolidation with multiple small cavities had significant difference between two groups. However, the occurrence of extra-chest lesions had no significant difference between two groups (P＞0.05). No significant difference was found in ages between two groups (P＞0.05). The number of CD4 T lymphocytes had significant difference between the groups (P＜0.001). Conclusion The imaging findings were closely associated with CD4 T lymphocyte count in AIDS with pulmonary tuberculosis. Image features of AIDS patients with pulmonary tuberculosis include infiltrating multi-lobes and atypical location. Pulmonary tuberculosis in AIDS often showed many atypical faces concomitance. |
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