MSCT在涂阴培阳肺结核患者治疗前后的应用研究

目的 探讨多层螺旋CT（multidetector CT，MSCT）在涂阴培阳肺结核治疗前后的价值。方法 回顾性收集2017年1月至2021年8月在台州市立医院登记治疗、资料完整的涂阴培阳肺结核患者95例，由两名胸部组放射专家阅片，分析、记录、比较治疗前及随访6月至12月时MSCT表现结果。结果 95例涂阴培阳肺结核中，治疗前后涂阴培阳活动性肺结核MSCT征象检出率分别为100%（95/95）、33.68%（32/95）；治疗前后涂阴培阳肺结核活动性各种CT征象检出率比较，抗结核治疗后各种活动性CT征象检出率明显减少（P<0.05）；涂阴培阳肺结核非活动性CT征象检出率比较，非活动性肺结核CT 征象中除钙化外，其他斑块、边缘清晰的高密度结节、条索影、支气管扩张、肺结构扭曲变形等征象治疗结束后检出率增加（P<0.05）。结论 MSCT可明确涂阴培阳肺结核的病变征象和其治疗前、后征象转归情况，对病变疗效评价具有较高的价值。

Value of MSCT in negative-smear and positive-culture pulmonary tuberculosis before and after the treatment

Objective To investigate the value of multi-slice spiral CT (MSCT) in negative-smear and positive-culture pulmonary tuberculosis before and after the treatment. Methods A total of 95 patients of negative-smear and positive-culture pulmonary tuberculosis registered in our hospital with complete data from January 2017 to August 2021 were retrospectively collected. Their CT findings and outcomes before treatment and during the follow-up period from 6 to 12 months were analyzed by two chest imaging experts. Results The MSCT signs of active negative-smear and positive-culture pulmonary tuberculosis before and after treatment were 100% (95/95) and 33.68%(32/95), respectively. In the active signs, the detection rates of central lobular nodules, tree bud sign, acinar nodules, lobular consolidation, ground-glass shadow, blurred margin consolidation, bronchial thickening, thick-walled cavity, and small cavity in multiple nodules were 95.8%, 91.6%, 83.2%, 78.9%, 53.7%, 26.30%, 23.2%, 9.47%, respectively. In the inactive signs, high-density shadow with clear edge and plaque can be further absorbed. After treatment, banded shadow, high density shadow with clear edge, plaque, distortion and deformation of lung structure can be increased. Conclusion MSCT can clarify the signs of negative-smear and positive-culture pulmonary tuberculosis and the outcome before and after treatment, which has a high value in evaluating the curative effect.