非活动性结核性胸膜炎与活动性结核性胸膜炎的CT扫描影像特征分析

目的: 探讨非活动性结核性胸膜炎与活动性结核性胸膜炎CT扫描影像表现。方法: 对2012年6月1日至2021年3月30日在首都医科大学附属北京胸科医院就诊的单纯非活动性结核性胸膜炎患者68例和同期活动性结核性胸膜炎44例的CT扫描影像表现进行比较。结果: (1) 68例非活动性结核性胸膜炎患者 CT扫描影像表现中胸膜粘连62例(91.2%),胸膜有钙化者28例(41.2%),叶间裂受累22例(32.4%),胸腔积液12例(17.6%),包裹性胸腔积液8例(11.8%)。(2)44例活动性结核性胸膜炎患者CT扫描影像表现中胸膜粘连30例(68.2%),未见胸膜钙化,叶间裂受累32例(72.7%),胸腔积液43例(97.7%),包裹性胸腔积液26例(59.1%)。(3)非活动性与活动性结核性胸膜炎CT扫描影像比较:胸膜粘连、胸膜钙化发生率高,差异均有统计学意义(χ²=9.630,P=0.002;χ²=23.737,P=0.000);叶间裂受累、胸腔积液、包裹性胸腔积液的发生率低,差异均有统计学意义(χ²=12.692,P=0.000;χ²=68.548,P=0.000;χ²=28.301,P=0.000)。结论: 非活动性结核性胸膜炎的CT扫描影像与活动性结核性胸膜炎比较胸膜粘连、胸膜钙化的发生率高,胸腔积液、包裹性胸腔积液、叶间裂受累的发生率低。识别非活动性和活动性结核性胸膜炎的CT扫描影像特点,对患者临床治疗有指导意义。

CT imaging of inactive tuberculous pleurisy and active tuberculous pleurisy

Objective: To investigate computed tomography (CT) features of inactive and active tuberculous pleurisy. Methods: A total of 68 patients with pure inactive tuberculous pleurisy admitted to Beijing Chest Hospital affiliated to Capital Medical University from June 1, 2012 to March 30, 2021 were analyzed retrospectively, and compared with the CT findings of 44 patients with active tuberculous pleurisy during the same period. Results: (1)The CT findings of inactive tuberculous pleurisy (68 cases):pleural adhesion 62 cases (91.2%), pleural calcification was 28 cases (41.2%), interlobular fissure involvment in 22 cases (32.4%), pleural effusion 12 cases (17.6%), and encapsulated effusion 8 cases (11.8%). (2)The CT findings of active tuberculous 44 cases: pleural adhesion 30 cases (68.2%), no pleural calcification was observed, pleurisy interlobular fissure involvement 32 cases (72.7%), pleural effusion 43 cases (97.7%),and encapsulated effusion 26 cases (59.1%). (3) Comparison of CT scan images of inactive and active tuberculous pleurisy: the incidence of pleural adhesion and pleural calcification were higher, with statistical significance (χ²=9.630,P=0.002;χ²=23.737,P=0.000, respectively); the incidence of interlobar fissure involvement, pleural effusion and encapsulated pleural effusion was lower, and the differences were statistically significant (χ²=12.692,P=0.000;χ²=68.548,P=0.000;χ²=28.301,P=0.000,respectively). Conclusion: In comparison of CT scan images of inactive and active tuberculous pleurisy,the incidence of pleural adhesion and pleural calcification of inactive tuberculous pleurisy was higher but the incidence of pleural effusion, encapsulated effusion, and interlobar fissure involvement was lower. The identification of CT scan features of inactive and active tuberculous pleurisy is helpful to guide clinical treatment of patients.