低剂量CT扫描在评价老年菌阴性肺结核患者抗结核治疗效果中的应用

目的 采用低剂量CT扫描对老年菌阴性肺结核患者抗结核治疗效果进行评价.方法 对47例菌阴性肺结核抗结核治疗后1～12个月复查的老年患者采用低剂量CT扫描(120 kV,20 mAs),通过与治疗前常规CT(120 kV,200～280 mAs)扫描影像学结果的比较,对老年菌阴性肺结核患者抗结核治疗效果进行评价.结果 老年菌阴性肺结核患者初诊CT征象最常见的为腺泡实变融合和肺叶/肺段实变,其发生率分别为100.0和76.6%,而空洞的发生率相对较少;1～3个月复查好转的征象主要为树芽征,而腺泡融合实变和肺叶/肺段实变的好转主要发生于4～9个月,空洞性病变显效较慢,持续时间为6～12个月.结论 低剂量CT扫描能较好地反映老年菌阴性肺结核的不同影像学征象及抗结核治疗后的影像学,适合对老年菌阴性肺结核患者治疗后的效果进行评价.

Abstract：

Objective To evaluate the therapeutic effect of antituberculosis therapy in elderly patients with smear-negative pulmonary tuberculosis by low-dose computed tomography (CT).Methods Forty-seven elderly patients diagnosed as smear-negative pulmonary tuberculosis were rechecked with low-dose chest CT scan (120 kV, 20 mAs) after 1-12 months of antituberculous therapy respectively. These images were compared with common CT before treatment (120 kV, 200-280 mAs). Results In the elderly patients with smear-negative pulmonary tuberculosis, the most common CT signs before treatment were acinus consolidation (100%) and lobar or segmental consolidation (77%), but the cavity was seen less. After effective antituberculous therapy, tree-inbud was improved after one to three months, the acinus consolidation and lobular or segmental consolidations were improved after four to nine months, and the cavitations were slowly improved after six months. Conclusions Low-dose CT can provide sufficient information for the therapeutic effects of antituberculous therapy of smear-negative pulmonary tuberculosis in the elderly and could be used for rechecking.

Therapeutic effects of smear-negative pulmonary tuberculosis in the elderly after antituberculosis therapy evaluated by low-dose Computed Tomography

Objective To evaluate the therapeutic effect of antituberculosis therapy in elderly patients with smear-negative pulmonary tuberculosis by low-dose computed tomography (CT).Methods Forty-seven elderly patients diagnosed as smear-negative pulmonary tuberculosis were rechecked with low-dose chest CT scan (120 kV, 20 mAs) after 1-12 months of antituberculous therapy respectively. These images were compared with common CT before treatment (120 kV, 200-280 mAs). Results In the elderly patients with smear-negative pulmonary tuberculosis, the most common CT signs before treatment were acinus consolidation (100%) and lobar or segmental consolidation (77%), but the cavity was seen less. After effective antituberculous therapy, tree-inbud was improved after one to three months, the acinus consolidation and lobular or segmental consolidations were improved after four to nine months, and the cavitations were slowly improved after six months. Conclusions Low-dose CT can provide sufficient information for the therapeutic effects of antituberculous therapy of smear-negative pulmonary tuberculosis in the elderly and could be used for rechecking.