目的 分析CT检查糖尿病(DM)合并肺结核(TB)的诊断价值.方法 选取我院2019年1月—2020年1月CT检查患者50例,根据病情分为两组,实验组(25例,DM合并TB患者)和对照组(25例,单纯TB患者),比较其诊断效果.结果 从结核病变部位来看,在实验组中,检出3例肺部浸润性病变,占比为12％(3/25).在对照组25名患者中,检出4例肺部浸润性病变,占比为16％(4/25).x2检验显示,两组患者结核病变部位无明显差异(P>0.05);但在另一方面,与对照组相比,实验组干酪样病变、空洞形成更多,

目的:分析探讨多层螺旋C T成像及三维重建在支气管结核诊断中的应用价值.方法:随机抽取2019年8月至2021年4月本院就诊支气管结核患者80例,患者均通过医学诊断标准确定为支气管结核患者,按随机表法分为研究组和常规组患者各40例,常规患者采取常规CT检查诊断,研究组患者采取多层螺旋CT成像及三维重建诊断方式,记录两组患者肺不张、支气管播散、淋巴结增大以及胸腔积液检查结果,比较两组患者诊断准确率以及患者满意度情况.结果:研究组患者总满意度为95.00％,常规组患者总满意度为72.50％,研究组总满意度高于对比组(χ2=5.8373,P=0.0156),两组患者数据组间比较差异,结果有统计学意义(P<0.05);研究组患者的诊断准确率为100.00％,常规组患者诊断准确率为87.50％(χ2=4.1846,P=0.0407),两组患者数据组间差异比较,分析结果具有统计学意义(P<0.05).结论:多层螺旋CT成像及三维重建在支气管结核诊断中的应用价值明显,能够提升检查结果的准确性,避免漏诊的发生,为治疗提供依据,利于疾病的整体治疗,值得临床应用.

目的 探讨CT引导下肺穿刺活检术结合术中快速病理诊断后灌注治疗的临床应用及疗效.方法 选取哈尔滨市胸科医院2019年3月～2020年7月160例采取CT引导下肺穿刺活检术的患者,随机分为肺穿刺活检后行常规病理检查组及穿刺活检术结合术中快速病理检查组,每组80例,两组均与术后最终大病理(包括活检病理、外科手术病理、后续临床证实)对比,分析各自的检出率与准确率.并对术中明确诊断的13例非小细胞肺癌行缓释顺铂灌注治疗.结果 术中快速病理阳性检出率为92.5％(74/80),明显高于常规病理方法77.5％(62/80)(x2=7.059,P=0.008).术中快速病理诊断准确率为80.0％(64/80),明显高于常规病理方法60.0％(48/80)(x2=7.619,P=0.006);瘤内植入缓释顺铂治疗非小细胞肺癌患者13例,病灶明显缩小3例,稳定8例,进展2例.结论 CT引导下肺穿刺活检术结合术中快速病理诊断可显著提高阳性检出率和准确率;瘤内植入缓释顺铂治疗非小细胞肺癌有较好的耐受性、安全性和疗效.

目的 探讨首次诊断复治涂阳肺结核患者中医辨证证候型与肺CT检查所见征象的相关性.方法 将58例肺结核患者进行中医辨证,分为肺阴虚型、阴虚火旺型和气阴两虚型,分析各证候型与肺CT检查所见征象之间的相关性.结果 58例患者中肺阴虚型23例,占39.66％,肺CT征象以渗出病变、腺泡结节病变为主;阴虚火旺型19例,占32.76％,肺部病灶呈广泛性分布,肺CT征象以干酪病灶、浸润病灶为主并伴有空洞性改变;气阴两虚型16例,占27.59％,肺部病灶逐渐增大,呈反复破坏和修复改变,肺CT征象在干酪、浸润、空洞病灶基础上呈现增殖、纤维化,甚至出现肺萎陷、毁损.结论 复治涂阳肺结核中医辨证证候型与其肺部CT征象存在一定的相关与规律性,对肺结核中医辨证分型诊断和治疗具有较重要的实用价值.

目的:探讨局灶性机化性肺炎的CT特点及其诊断价值。方法:分析15例局灶性机化性肺炎的CT特点。结果:15例皆位于胸膜下,8例相应胸膜异常,2例类圆形,13例不规则形,15例密度不均,3例有小支气管像,2例有小空洞,6例边缘模糊,7例周围毛刺或索条,8例支气管血管束异常,2例病灶内低密度,4例肺间质改变,4例纵隔淋巴结肿大,2例有卫星灶。结论:局灶性机化性肺炎CT有一定的特点,但不典型机化性肺炎与周围型肺癌,肺结核鉴别尚有一定困难,需病理支持。

目的探讨系统性硬化病的肺部影像学表现。方法9例系统性硬化病患者,对其肺部影像学的表现进行分析。结果常规X线显示肺纹理增多,紊乱,但不如CT明显,HRCT扫描显示网格样,蜂房样变,小叶间隔增厚,间质病变明显。结论HRCT对观察系统性硬化病的肺部改变及预后具有优越性。

患者1,女,68岁."进食饱胀感4个月,胃部不适5年余"入院.腹部CT:胃小弯前壁可见4.60 cm×4.00 cm×4.30 cm大小的软组织肿块,突向胃腔,局部胃腔狭窄,边缘光滑,与周围组织界限清晰,病变密度均匀,平扫CT值30 HU,增强后强化明显,动脉期90 HU.CT诊断:胃基质瘤.行胃大部切除术,术中见胃窦角切迹小弯侧前壁可见5.00 cm×4.00 cm×4.00 cm大小外生型肿块,包以黄色被膜.病理诊断:胃神经鞘瘤.

肺曲菌病是一种少见病,是肺霉菌病中的一种特殊类型.近年来由于抗生素及激素的滥用,破坏了菌群间的相互抑制作用及降低了机体的免疫机能,使其发病率呈上升趋势.我院遇有2例,经CT扫描及经气管插管抽吸痰液进行涂片和培养证实.现报告如下.

Objective Our study was to describe the CT findings of pulmonary tuberculosis in baby and to sum up the characteristic CT findings.Methods 18 cases of pulmonary tuberculosis,whose age were under 3 years,including 6 cases acute pulmonary military tuberculosis and 12 cases non-military pulmonary tuberculosis were retrospectively analyzed by two radiologists.CT images in these cases were assessed for the presence of military shadow,acinar shadow,air space consolidation,air bronchogram,lobar consolidation or atelectasis,enlargement of lymph node,cavity,fibrosis and calcification,and distribution of abnormal attenuation.Results Acute military tuberculosis showed military shadow with homogeneous distribution(6/6).Non-military tuberculosis showed air space consolidation with lobular and segmental distribution(9/12),air brouchogram(7/12),enlargement lymph node of hilar or mediastinal(7/12),acinar shadow(6/12),and lobar consolidation or atelectasis(5/12).Conclusion Characteristic CT findings of baby acute military pulmonary tuberculosis is military shadow with homogeneous distribution.Characteristic CT findings of non-military baby pulmonary tuberculosis is polymorphism air space consolidation mix existing and Mediastinal and hilar lymphadenopathy.These CT features seem to reflect pathologic specialty and the progression of the lesion development.This information maybe helpful to the early diagnosis of the baby pulmonary tuberculosis.

对我院2005-12～2006-09 CT误诊多发球形肺炎13例分析如下. 1 临床资料 1.1 一般资料 本组男9例,女4例,年龄17～45(平均32)岁,病程10 d～4个月.临床表现:发热咳嗽10例,白痰6例,无痰7例,喘息3例,胸背痛8例,无症状体检1例.本组经皮肺活检病理证实4例,痰病原体培养证实2例,余临床抗炎对症治疗治愈证实7例.

Objective To discuss the CT manifestation and classification of bronchial tuberculosis. Methods 35 xases of BTB were analyzed with CT manifestation and reconstruction combined with bronchoscope retrospectively. Results The classification could be divided into four types: fibro-stenosis, wall thickness; unexpanded and tumor-like. Conclusion CT detection and reconstruction might have important value for diagnosis and differential diagnosis.

Objective To discuss the clinical manifestation and diagnostic value of CT in tuberculosis pleuritis (TP). Methods The manifestation and classification of 125 cases TP were analyzed retrospectively. Results There were 4 type of TP. Type Ⅰ was simple exudation pleuritis; Type Ⅱ was simple local lesion; Type Ⅲ was exudation and local lesion; Type Ⅳ was chronic pleural lesion. Conclusion CT might have important value to obtain the diagnosis, differential diagnosis, complication and assessment of lesion activity.

Objective To discuss the CT manifestation of secondary pulmonary tuberculosis (SPT). Methods The CT materials of 15 cases of SPT infant patient were analyzed and summarized retrospectively. Results There were 8 cases of patch and cloudy high density. There were 6 cases of segment and lobular consolidation. There was 1 case of nodular density and 4 cases of hydrothorax. There were 13 cases of lymph node enlargement with calcification. Conclusion The CT manifestation of SPT of infant might be most of patch, infiltrated and cheese like pneumonia that different with adult's.