目的探讨艾滋病(AIDS)并发肺结核肺内播散的影像特点。方法回顾性分析经临床及实验室检查证实的33例AIDS并发肺结核肺内播散的x线胸片及MSCT影像资料，总结其影像表现特征。结果首诊X线胸片检查30例，29例表现异常，包括病灶呈双侧播散性分布2l例，单侧多发病变8例。所有患者均行MSCT扫描，病变呈单侧和双侧肺内多发分布分别为7例和26例；病变形态包括结节(25例)、粟粒(22例)、气腔实变(22例)、空洞(11例)、纤维索条(7例)、磨玻璃影(7例)、肺气囊(4例)、钙化(2例)。肺内病变形态包含3种以上表现者20例，1种和2种表现者13例。33例患者的肺外结核包括胸膜受侵33例，淋巴结受累30例，肠结核3例，肾结核2例，脾结核1例，结核性脑膜炎1例。结论AIDS患者肺内H{现累及多叶、多段的弥漫性结节、粟粒、气腔实变或多发空洞，同时伴淋巴结受累、胸膜浸润，应高度提示播散性肺结核感染!
结核，肺；获得性免疫缺陷综合征；体层摄影术，X线计算机
ImagingfindingsofdisseminatedpulmonarytuberculosisinpatientswithacquiredimmunodeficiencysyndromeSONGWen一弘n4，ZHAOZu—qi，ZHAODa—wet，LIUJin—xin，GUANWan—hua，LIANGYi，flACui—yu，ZHANGRut—c舷*DepartmentofRadiology，BeijingYouanHospital，CapitalMedicalUniversity，Bering．ChinaCorrespondingauthor：LIUJin—xin，DepartmentofRadiology，theEighthPeopleHospitalofGuangzhou，Guangzhou，China，Email：liujx
．cornObjectiveTostudytheimagingfindingsofdisseminatedpulmonarytuberculosisinpatientswithacquiredimmunodeficiencysyndrome(AIDS)．MethodsX—rayandmulti—sliceCT(MSCT)datafrom33AIDSpatientswithdisseminatedpuhnonarytubereulosisconfirmedbyclinicalmanifestationsandlaboratorytestswereanalyzedretrospectively．ResultsThiwpatientsunderwentinitialchestradiographyexamination，29patientsshowedabnormalappearances，includingbilateraldisseminationsin21patientsandunilateralmultipledisseminationsin8patients．AllpatientsunderwentMSCTexamination，26patientsshowedbilateraldisseminationsand7patientsshowedunilateralmultipledisseminations．Theabnormalpulmonaryappearancesincludednodule(n=25)，miliarynodule(凡=22)，air—spaceconsolidation(n=22)，cavity(n=11)，fibrosis(n=7)，ground—glassopacity(n=7)，pneumatocele(n=4)，calcification(n=2)．Therewere20patientswithmorethan3abnormalappearancesand13patientswithoneortwoabnormalappearances．Theextra—pulmonarytuberculosisincludedpleuraleffusion(n=33)，lymphadenopathy(n=30)，intestinaltuberculosis(H=3)，splenictuberculosis(n=1)andcerebraltuberculosis(n=1)．ConclusionDisseminatedpulmonarytuberculosisshouldbehighlysuspectedinAIDSpatientswithdiffusednodules，miliarynodules，air—spaceconsolidationsormuhiplecavities，ac
