活动性及非活动性肺结核CT征象对不同类型肺结核的鉴别诊断价值

目的探讨活动性及非活动性肺结核CT征象在新发、复发及慢性肺结核中的表现。方法以我院放射科收治的148例肺结核患者作为研究对象,包括45例新发型结核患者(A组)、53例复发型结核患者(B组)以及50例慢性结核者(C组),根据其临床资料进行回顾性分析。结果 A组、B组活动性CT征象(树芽征、肺实变、毛玻璃阴影、节段性分布小叶中心结节影)的检出率明显高于C组,后壁空洞检出率低于C组,差异显著(P0.05);A组活动性CT征象与B组相比,无显著差异(P0.05)。C组非活动性CT征象(肺气肿、支气管聚拢迂曲、纤维条索影、钙化)的检出率明显高于A组、B组,差异显著(P0.05);B组非活动性CT征象检出率高于A组,差异显著(P0.05)。结论活动性及非活动性肺结核CT征象在新发、复发及慢性肺结核中的表现均存在显著差异,其征象具有一定的特征性,通过对活动性及非活动性肺结核CT征象进行分析,可对临床诊治肺结核提供重要依据。

The Differential Diagnosis Value of Active and Non-Active Tuberculosis CT Signs in Emerging,Recurrent and Chronic Pulmonary Tuberculosis

Objective To study manifestations of active and non-active tuberculosis CT signs in emerging, recurrent and chronic pulmonary tuberculosis. Methods One hundred and forty tuberculosis patients admitted by the Radiology Department of the Hospital were selected as research subjecting, including 45 patients with emerging TB patients (Group A), 53 patients with recurrence tuberculosis (Group B), and 50 patients with chronic tuberculosis (Group C), and retrospective analysis was made according to clinical data. Results The positive rate of active CT signs (tree-in-bud sign, pulmonary consolidation and ground glass shadow, segmental distribution lobules center nodular shadow) of patients in Group A and Group Bwere much higher than those of Group C, and the positive rate of posterior wall of patients in Group A and Group B was lower than of patients in Group C, and the difference were significant (P<0.05). Active CT sign of patients in Group A was not of no significant difference when compared to that of patients in Group B(P>0.05). Inactive CT signs of patients in Group C (emphysema, gathered bronchial circuity, fibrosis image, calcification) were significantly higher than those of patients in Group A and Group B, and the differences were significant (P<0.05. The positive rate of inactive CT sign of patients in Group B was higher than that of patients in Group A, and the difference was significant (P<0.05). Conclusion The demonstrations of active and non-active tuberculosis CT signs in emerging, reoccurrence and chronic recurrent pulmonary tuberculosis show significant differences, and their manifestations deliver certain characteristics. Important basis are provided to clinical diagnosis and treatment for tuberculosis through the analysis on active and non active tuberculosis CT signs.