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目的 探讨食管结核的影像学表现 ,提高对该病的认识。方法 回顾性分析 5例经病理证实的食管结核 ,男 2例 ,女 3例 ,年龄 2 4～ 3 6岁 ,平均 2 9岁。 5例均行食管钡剂造影、CT和电子纤维胃镜检查 ,1例行手术治疗。结果 食管钡剂造影示 :食管上段 1例 ,中段 3例 ,下段 1例 ,表现为充盈缺损 2例 ,向心性狭窄 2例 ,腔内点状钡斑 1例 ,腔外不规则窦道形成 1例。黏膜纹破坏2例 ,平坦或消失 3例。胸部CT平扫 :1例左肺下叶后基底段支气管扩张 ,右肺门增大 ,右胸壁有小结节 ;1例食管下段管壁不规则增厚 ;1例胸膜肥厚粘连 ;2例未见明显异常。术前影像学误诊 3例 ,正确诊断 2例。结论 食管结核缺乏影像学的特点 ,诊断应密切结合临床。
Objective To explore the imaging findings of esophageal tuberculosis and improve the understanding of the disease. Methods Retrospective analysis of 5 cases of pathologically confirmed esophageal tuberculosis, 2 males and 3 females, aged 24 to 36 years, mean 29 years. 5 patients underwent esophageal barium contrast, CT and electronic fiber endoscopy, 1 case of surgical treatment. The results of esophageal barium angiography showed: the upper esophagus in 1 case, the middle section in 3 cases, the lower section in 1 case, manifested as filling defect in 2 cases, concentric stenosis in 2 cases, cavity punctate barium spot in 1 case, extracavitary irregular sinus tract formation 1 example. Mucosa rupture in 2 cases, flat or disappeared in 3 cases. Chest CT scan: 1 case of left lower lobe basilar bronchiectasis, right hilar enlargement, right chest wall nodules; 1 cases of irregular esophageal thickening of the wall; 1 case of pleural thickening adhesions; 2 cases did not See obvious abnormalities. Preoperative misdiagnosis of 3 cases of imaging, the correct diagnosis of 2 cases. Conclusion Esophageal tuberculosis lack of imaging features, diagnosis should be closely combined with clinical.