31例活动性肺结核治疗前及治愈后的CT征象分析

目的探讨抗结核疗前及治愈后活动性肺结核CT征象的变化特点。方法选取临床治愈的活动性肺结核31例,对比观察活动性肺结核的CT征象转归表现。结果肺结核活动性CT征象治愈前检出率为100.0%,治疗后检出率为35.5%。活动性CT征象中毛玻璃阴影、节段分布小叶中心结节影、小叶样实变影、树芽征、支气管壁增厚、厚壁空洞和肺实变治疗前检出率分别为87.1%、80.6%、80.1%、61.3%、58.1%、48.4%和32.3%、,治愈后检出率分别为0、19.4%、0、0、12.9%、0和3.2%。治疗前活动性肺结核CT检查可检出多种活动性影像,而疗程结束后上述征象减少并多以单发为主,两者有显著差异(P<0.01)。结论CT检查有助于活动性肺结核治疗疗效的判定,并具有较高的敏感度,但特异度较低。

Comparison analysis of CT images of 31 active pulmonary tuberculosis case between the active and post-treatment phases

Objective To study the change of pulmonary tuberculosis(TB) CT image in the active and post-treatment phases.Methods Thirty-one active TB patients were selcted to do spiral CT scan to observe the change of the image before and after treatment. Results It showed that check-out rate of active images was 100.0% before treatment and 35.5% after treatment.The most higher check-out rate of active image was ground-glass opacity(87.1%),followed by centrilobular nodules with segmental distribution(80.6%),lobular consolidation(80.1),tree in bud(61.3%),thickening of the bronchial walls(58.1%),thick-wall cavity(48.4%),segmental or lobar consolidation(32.3%) at the start of the treatment.While after completion of the treatment,the check-out rate of those image changed to 0,19.4%,0,0,12.9%,0,3.2% respectively.Many kinds of active CT image which can be found before treatment were reduced and mainly showed one single image in one patient after the treatment.The difference was significant(P<0.01). Conclusion CT was helpful to judge treatment effect of active TB with high sensitivity but low specificity.