新发、复发及慢性肺结核CT征象的比较研究

目的探讨不同类型活动性肺结核的CT表现特征。方法搜集新发活动性肺结核51例,复发肺结核54例,慢性肺结核34例全部行螺旋CT检查,对比观察三种活动性肺结核的CT征象表现异同。结果活动性CT征象:毛玻璃阴影、节段性分布小叶中心结节影、树芽征、肺实变和厚壁空洞在新发肺结核检出率分别为88．2％、82．4％、66．7％、27．5％和37．3％;复发肺结核分别为92．6％、72．2％、59．3％、33．3％和24．1％;慢性迁延性肺结核分别为38．2％、41．2％、32．3％、8．8％和76．4％。毛玻璃阴影和节段性分布小叶中心结节影、树芽征和肺实变的检出率在新发与复发病例间无显著差异性P＞0．05,均明显高于慢性肺结核(P＜0．01)。而慢性肺结核厚壁空洞均高于新发和复发病例(P＜0．01);非活动性CT征象:纤维索条影和支气管聚拢迂曲在新发肺结核检出率分别为5．9％和17．6％;在复发肺结核分别为48．1％和40．7％;在慢性肺结核分别为88．2％和85．3％。3组间均有显著性差异。结论活动性CT征象在新发和复发活动性肺结核和慢性肺结核检出率不尽相同,CT有助于肺结核活动性的判断。但尚需密切结合临床和痰菌检查。

Comparison research about active CT imaging in newly diagnosed, relapsed and chronic pulmonary tuberculosis

Objective To explore CT imaging characteristics in three kinds of active pulmonary tuberculosis (TB). Methods Spiral CT scan was applied to 51 newly diagnosed TB cases, 54 relapsed TB cases and 34 chronic TB cases. The difference of the CT imaging among the three kinds of TB cases were observed. Results Active CT imaging: the check-out rates of ground-glass opacity, centrilobular nodules with segmental distribution, tree in bud, segmental or lobar consolidation,thickening of the bronchial walls and thick-walled cavity was 88.2%, 82.4%, 66.7%, 27.5%, 37.3% respectively in newly diagnosed cases; 92.6%, 72.2%, 59.3%, 33.3%, 24.1% respectively in relapsed cases and 38.2%, 41.2%, 32.3%, 8.8%, 76.4% respectively in chronic cases. There was not significant difference of the above check-out rates between new and relapsed cases ( P > 0.05) , while the check-out rates in new and relapsed cases were all obvious higher than those in the chronic cases ( P < 0.01) . The check-out rate of thick-walled cavity was obvious more higher than new diagnosed cases and relapse case. Inactive CT imaging: the check-out rates of fibre rope band and bronchial flection were 5.9% and 17.6% in newly diagnosed case, 48.1% and 40.7% in relapsed cases and 88.2% and 85.3% in chronic cases respectively. The difference was significant among three kinds of TB cases ( P < 0.01). Conclusion The check-out rates of active CT Image is different among newly diagnosed case, relapsed case and chronic case. CT is helpful to their differential diagnosis, while carefully considering the clinical symptoms and sputum examinations at the same time.