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目的探讨胸膜结核球的影像表现,以提高对其认识。方法回顾分析23例,其中11例经手术病理证实,4例伴有肺结核和8例病变同侧结核性渗出性胸膜炎。经治疗随访确诊胸膜结核球的X线平片表现,其中CT检查18例和MRI检查6例。结果23例中X线胸部平片呈圆形9个,椭圆形6个,病灶密度均匀,边缘清楚。CT检查18例,胸膜病灶形态为乳头状6例,卵圆形11例,1例形状不规则。CT平扫呈等密度11例,稍高密度5例,混杂密度2例。病灶边界清楚13例,部分模糊5例。6例MRI检查的病例形态为乳头状形4例,卵圆形2例。其中病灶表现为T1WI上呈略低信号,T2WI上中等或略高信号,增强后病灶显著均匀增强2例;病灶表现T1WI上呈低、等信号,T2WI上略高或混杂信号,增强后病灶中央呈低信号,周边呈薄壁环形强化4例。结论X线平片检查可作为发现病变的首选方法,而该病CT及MRI检查的表现较具特征性。
Objective To investigate the imaging manifestations of pleural tuberculoma to improve their understanding. Methods Retrospective analysis of 23 cases, of which 11 cases were confirmed by surgery and pathology, 4 cases with tuberculosis and 8 cases of ipsilateral tuberculous exudative pleurisy. The follow-up of treatment confirmed pleural tuberculosis X-ray film performance, including CT examination in 18 cases and MRI in 6 cases. Results In 23 cases, X-ray chest radiographs were round 9 and oval 6, with uniform density and clear margin. CT examination in 18 cases, pleural lesions in 6 cases of papillary, ovoid in 11 cases, 1 case of irregular shape. CT scan showed equal density in 11 cases, slightly higher density in 5 cases, mixed density in 2 cases. Thirteen cases were clearly borderline and 5 were partial fuzzy. Six cases of MRI examination of the shape of the papillary shape in 4 cases, oval in 2 cases. The lesion showed a slightly lower signal on T1WI and a moderate or slightly higher signal on T2WI, and two lesions were significantly and uniformly enhanced after enhancement. The lesion showed low and equal signals on T1WI and slightly higher or mixed signal on T2WI, Showed a low signal, the surrounding thin-walled ring enhanced in 4 cases. Conclusion X - ray examination can be used as the first choice for detecting lesions. CT and MRI findings of the disease are more characteristic.