Abstract: Objective To investigate and analyze the features of atypical CT image of pulmonary tuberculosis. Methods  A retrospective analysis of 73 cases of tuberculosis with atypical CT image of our hospital from January 2010 to September 2012 was done to classify all cases into various types due to their image characteristics.  Results According to the image characteristics, all cases were divided into 6 types including: type of multiple cavitates, 7 cases, showed multiple pulmonary cavitates without tuberculosis disseminated lesions; type of interstitial lesions, 20 cases, showed intrapulmonary large fine mesh weave-like higher density shadows with clear boundary, consolidation in it and multiple thickening interlobular septa perpendicular to the pleural were also seen; type of snowflake, 16 patients(4 with interstitial change), showed that multiple acinar nodules distributed around the small bronchi and its branches, and formed feeding bronchus sign, multiple “tree-in-bud” and lobular consolidation in it; type of mass, 29 cases, showed that the edge was found smooth, lobulation, long burr, pleural indentation signs, no short glitches sign, intermediate density was seen in all masses on CT plain scan, 3 cases with rim enhancement, 7 with homogeneous enhancement; type of hilar and mediastinal lymphoid tuberculosis with pseudoaneurysm, 1 cases, showed pseudoaneurysm in rim enhancement lymph node; type of consolidation, 4 cases, showed multiple segment, lobe consolidation with normal endobronchial sign.  Conclusion Type of interstitial lesions, snowflake, hilar and mediastinal lymphoid tuberculosis with pseudoaneurysm of these 6 types of atypical CT image of pulmonary tuberculosis have a certain degree of specificity to be diagnosed, but clinical and laboratory tests are still needed to be combined with in all types.

Key words: Tuberculosis, pulmonary/radiography, Tomography, X-ray computed