64层螺旋CT多方位重组技术联合仿真内镜技术诊断支气管结核的应用价值

目的 探讨64层螺旋CT多方位重组(CTMPR)技术联合仿真内镜技术(CTVE)对支气管结核的诊断效能和应用价值。 方法 选取2013年4月至2016年12月河北省胸科医院收治疑似支气管结核患者122例,采用64层螺旋CTMPR和CTVE检查,以纤维支气管镜(FOB)病理学诊断为金标准,衡量其诊断效能。 结果 经FOB最终确定108例支气管结核,CTMPR联合CTVE技术诊断的敏感度、特异度、阳性预测值、阴性预测值及准确率分别为92.6%、71.4%、96.2%、55.5%及90.2%。经FOB最终确定病变类型包括充血水肿型74处,浸润增殖型48处,溃疡肉芽型50处,瘢痕狭窄型46处,共218处；CT诊断相符的204处,符合率93.6%,不同FOB病变分型的CT表现差异有统计学意义(P<0.05)。经FOB最终确定并发症包括阻塞性肺不张26例、阻塞性肺炎18例、阻塞性肺气肿15例,共59例,CT诊断相符的有56例,符合率94.9%。 结论 64层螺旋CTMPR联合CTVE诊断支气管结核的准确率较高,是临床上重要的无创诊断技术。

Application value of CTMPR and CTVE technology in diagnose of endobronchial tuberculosis

Objective To explore the diagnostic efficiency and application value of 64-slice spiral CT multi-directional recombination (CTMPR) and virtual endoscopy (CTVE) technology in diagnose of endobronchial tuberculosis. Methods One hundred and twenty-two patients with suspected endobronchial tuberculosis who admitted to Hebei Chest Hospital from April 2013 to December 2016 were selected,all the patients were examined by CTMPR and CTVE technology,and its diagnostic efficiency was evaluated using fiber bronchoscope (FOB) as gold standard. Results 108 cases of endobronchial tuberculosis were determined by FOB,the sensitivity,specificity,positive predictive value,negative predictive value and accuracy rate of CTMPR and CTVE technology were 92.6%,71.4%,96.2%,55.5% and 90.2%,respectively.The type of 218 cases of lesions finally was confirmed by FOB including 74 cases of hyperemia oedema type,48 cases of infiltrating proliferative type,50 cases of ulcer granulation type,and 46 cases of cicatricial stricture type,the CT results had 204 lesions conformed to FOB,and the coincidence rate was 93.6%.There was significant difference in CT manifestation between different types of FOB lesions (P<0.05).59 cases of complications were confirmed by FOB,including 26 cases of obstructive atelectasis,18 cases of obstructive pneumonitis,and 15 cases of obstructive pulmonary emphysema,the CT results had 56 lesions conformed to FOB,and the coincidence rate of CT results was 94.9%. Conclusions CTMPR combined with CTVE technology has a high accuracy in the diagnosis of bronchial tuberculosis,and it is one of the important non-invasive diagnostic techniques in clinic.