赵爽

摘要：目的 分析胸骨结核CT影像表现及其在临床诊疗过程中的应用效果。方法随机抽选本院接收的40例经过手术病理确诊为胸骨结核患者，选取时间为2018年1月-2019年12月，所有患者均进行CT检查，对CT检查结果及影像表现进行分析。结果 CT诊断准确率是95.00%，与手术病理诊断对比，未见明显差异（P>0.05）;经过CT检查后，①发病位置：12例存在胸骨体受累，15例胸骨柄受累，4例胸骨柄体关节受累，7例胸骨柄、死骨及柄体关节同时受累。②死骨及骨质破坏：膨胀性骨质破坏、虫蚀状破坏、多囊状破坏、偏心状、混合型破坏分别有13例、9例、4例、4例、8例。死骨15例。③胸壁软组织脓肿、肿胀及窦道。12例胸部软组织发生肿胀，其中形成低密度寒性脓肿者9例，脓肿内存在钙化，而且以斑点状或者结节状呈现的有7例，形成胸壁瘘道的有4例。

结论 胸骨结核临床诊疗过程中，CT检查具有显著应用效果，其可以将疾病具体状况清楚的显示出来，包括患病部位、严重程度等，该检查方法为临床诊治提供的重要数据参考，值得临床进一步采纳与推广。

关键词：CT检查;影像表现;胸骨结核

[Abstract] Objective To analyze the CT imaging features of sternal tuberculosis and its application effect in clinical diagnosis and treatment. Methods 40 patients with sternal tuberculosis confirmed by surgery and pathology were randomly selected from our hospital. The time of selection was from January 2018 to December 2019. All patients underwent CT examination，and the CT examination results and imaging manifestations were analyzed. Results the diagnostic accuracy of CT was 95.00%，and there was no significant difference between CT and surgical pathology（P > 0.05）;After CT examination，the location of the disease：12 cases of sternal body involvement，15 cases of sternal stalk involvement，4 cases of sternal stalk joint involvement，7 cases of sternal stalk，dead bone and stalk joint involvement. ② Dead bone and bone destruction：there were 13 cases of expansive bone destruction，9 cases of wormhole destruction，4 cases of polycystic destruction，eccentric destruction and 8 cases of mixed destruction. There were 15 dead bones. ③ Chest wall soft tissue abscess，swelling and sinus. There were 12 cases of chest soft tissue swelling，including 9 cases of low-density cold abscess，7 cases of abscess with calcification，and 4 cases of chest wall fistula.

Conclusion in the process of clinical diagnosis and treatment of sternal tuberculosis，CT examination has a significant application effect，which can clearly show the specific condition of the disease，including the location and severity of the disease. This examination method provides important data reference for clinical diagnosis and treatment，and is worthy of further clinical adoption and promotion.

[Key words] CT examination;Imaging findings;Tuberculosis of sternum

胸骨結核是因为结核杆菌向骨关节入侵导致的化脓性破坏性病变，发病相对缓慢，包括两种分类型，分别是滑膜型结核与骨型关节结核，对患者身心健康和日常生活造成了严重影响。胸骨具备丰富的血液供应和解剖结构，但是胸骨结核发生率较低，主要是因为胸膜结核或者肺结核浸润造成的，具有胸骨前无痛性软组织肿胀、压迫症状、异常分泌物等症状^[1]。及早……