慢性肾功能衰竭合并肺结核的 CT 影像学误诊分析

摘要

目的：探讨慢性肾功能衰竭合并肺结核的CT影像学表现，减少肺部影像学误诊率。方法6例误诊为肺部其他感染的患者，均经临床证实为慢性肾功能衰竭合并肺结核，结合文献分析CT表现。结果6例患者中，双肺弥漫性斑片影伴肺实变3例；肺内多叶多段形态不规则的结节影和团块影2例；双肺多发斑片影、磨玻璃影和结节影1例；伴有纵隔淋巴结肿大者5例、胸腔积液4例。误诊为细菌性肺炎5例，真菌性肺炎1例。结论慢性肾功能衰竭合并肺结核的胸部CT影像学表现多样，应结合临床表现和实验室检查作出正确诊断。%Objective To investigate the CT findings in patients with chronic renal failure complicated with pulmonary tuber-culosis in order to reduce misdiagnosis rate of pulmonary images.Methods We combined literatures to analyze the CT features of 6 patients who were initially misdiagnosed as pulmonary infection but finally diagnosed as chronic renal failure complicated with pulmona-ry tuberculosis.Results In these patients,CT images showed 3 cases with diffuse patch of lung and pulmonary consolidation,2 cases with irregular nodules and masses in various lobes and segments and 1 cases with double lung multiple patchy shadows,ground glass shadow and nodule shadow.In addition,5 cases had enlarged mediastinal lymph nodes and 4 cases had pleural effusion.For the 6 pa-tients,5 cases were misdiagnosed as bacterial pneumonia and 1 case was misdiagnosed as fungal pneumonia (16.7%) .Conclusion The chest CT imaging of patients with chronic renal failure complicated with pulmonary tuberculosis were various.It should be combined with clinical manifestations and laboratory examination to make the correct diagnosis.