婴幼儿肺结核12例影像学表现分析

摘要

Objective To raise final diagnosis of infant' tuberculosis of lungs and toreduce misdiagnosis by approaching baby' imaging appearance.Methods Analyzing 12 cases of infant' tuberculosis of lungs of final diagnosis during near two yeas.Results In 12 cases,8 cases were to cough up phlegm,5 cases were being breathlessness and to gasp for breath,10 cases have a temperature,hyperthermia was understanding 40 ℃,minimum was 38 ℃,4 cases have night sweat,5 cases were being symptomsis,5cases have symptom of nervous system, there were 3 cases with headache and hyperspasmia,1 case with conscious disturbance;All cases were examined by normal side projection,among these there are 6 cases were examined by plain scan and enhancement scanning of CT;There were 7cases with acute miliary tuberculosis,3 cases with primary complex,2 cases with mediastinal lymphadenectasis, 1case with pure mediastinal lymphadenectasis;1 case with secnd pulmonary tuberculosis,1 case with superior' pulmonary atelectasis lobe of left lung;3 cases with tuberculous meningoencephalitis,1 case with spinal tuberculosis,1 case with Tuberculous abdominal cavity,3 cases with pleural fluid and pleural thickening among 12 cases.Conclusion Earlier diagnosis can be reached according by Baby' imaging appearance and clinical symptom, to treat in time.%目的 探讨婴幼儿肺结核的影像学表现,提高婴幼儿肺结核的早期正确诊断率,减少误诊.方法 选择近两年来经确诊的12例婴幼儿肺结核患者进行回归性分析.结果 12例患者中咳嗽咳痰8例,气促、喘息5例;发热10例,最高体温达40 ℃,最低38 ℃;盗汗4例,消瘦5例;有神经系统症状者5例,伴头痛、抽搐3例,意识障碍1例;12例全部行胸部正侧位X线检查,其中6例患儿行胸部和胸外器官的螺旋CT平扫及增强扫描:表现为急性粟粒性肺结核7例;原发综合征3例,其中2例并纵隔淋巴结肿大,1例单纯为纵隔淋巴结肿大;继发性肺结核1例,左肺上叶肺不张1例.12例中合并结核性脑膜脑炎3例,脊柱结核1例,腹腔结核1例(肝脾结核),伴有胸水和胸膜增厚者3例.结论 婴幼儿肺结核影像学具有一定的特点,结合临床症状及病史,可以早期作出诊断,为临床及时治疗提供依据.