【摘要】 目的 分析52例非常见部位肺结核的CT表现，提高CT对非常见部位肺结核的诊断及鉴别诊断能力。方法 对52例非常见部位肺结核患者(均经痰结核菌阳性、手术或穿刺活检病理证实)进行了常规胸部平片及CT扫描检查，其中28例加做HRCT扫描，9例团块状病灶加做增强扫描。结果 CT表现为多形性病变：腺泡结节状病变43例、渗出及实变36例、纤维化28例、钙化14例、空洞9例、团块状病灶(结核球)9例、胸膜改变48例。所有病例均有两种或两种以上病变并存，大多数病例伴有腺泡结节状病变和(或)局限性胸膜肥厚粘连。结论 非常见部位肺结核的CT表现具有一定特征，结合临床资料，大部分病例经CT可做出正确的诊断。

    【关键词】 肺结核；非常见；诊断；体层摄影术，X线计算机

    CT diagnosis for pulmonary tuberculosis in unusual position

    LI Dan,XIAO Wen-lian,LUO Guang-hua,et al.Department of Radiology,the First Affiliated Hospital,Nan Hua University,Hengyang 421001,China

    【Abstract】 Objective To analyze CT appearances of pulmonary tuberculosis in unusual position in 52 cases,and to improve the ability of CT diagnosis and differential diagnosis.Methods 52 cases of pulmonary tuberculosis in unusual position were performed by chest X-ray plan film and thoracic CT scan,of which 28 cases underwent HRCT,9 cases with masses underwent contrast enhancement.All cases were confirmed by positive tubercle bacilli of sputum,operation and pathology.Results CT appearances were pleomorphous:gland alveolus nodules lesions(n=43),exudation and consolidatinon (n=36),fibrosis(n=28),calcification(n=14),cavity(n=9),mass(tuberculoma) (n=9),pleural lesion(n=48).All the cases had simultaneously two or more lesions,and most cases were accompanied with gland alveolus nodules lesions and local pleural thickening and adhesion.Conclusion The pulmonary tuberculosis in unusual position had a certain of CT characteristics,and combined with clinical data,most cases could be correctly diagnosed. ......