多层螺旋CT仿真内窥镜对支气管内膜结核的诊断价值

目的 通过多层螺旋CT仿真内窥镜（CT virtual endoscop，CTVE）与纤维支气管镜（fiberoptic bronchoscope，FOB）的对比分析，研究CTVE对支气管内膜结核（endobronchial tuberculosis , EBTB）的诊断价值。 方法 临床诊断符合EBTB，并有结核病史，或最近3个月痰查抗酸杆菌阳性的患者61例，同时行纤维支气管镜检查及多层螺旋CT薄层连续容积扫描并进行CT仿真内窥镜后处理，用统计学方法对两组检查结果对比分析。结果 EBTB在CTVE的主要表现为气管腔不均匀狭窄（66.7%），均匀性狭窄23处（22.5%）。CTVE显示气管完全阻塞的11处（10.8%），其中2处在FOB为偏心性狭窄。2处浸润增殖型CTVE未能显示(6.4%)。CTVE发现4处FOB未能发现的支气管改变(3.8%)。CTVE对EBTB的检出率为85.2%，敏感度为92.3%，准确度为90.2%，特异度为71.4%。CTVE与纤维支气管镜检查对比，p>0.05, 差异无显著性。结论 CTVE与FOB检查在EBTB的检出方面具有较高的相符性及互补性，可作为安全、简便的诊断EBTB的手段。

Spiral CT virtual endoscopy of the diagnosis of endobronchial tuberculosis

Abstract] Objective multislice spiral CTVE (CT virtual endoscop) and FOB (fiberoptic bronchoscope,) Comparative analysis of CTVE on EBTB (endobronchial tuberculosis) diagnosis. Materials and methods of clinical diagnosis EBTB, and a history of tuberculosis, or check the last 3 months, sputum for AFB was positive in 61 patients, while fiberoptic bronchoscopy and spiral CT scanning with thin continuous volume CT simulation in endoscope reprocessing, using statistical methods compared two groups of test results. Results EBTB in CTVE showed uneven tracheal lumen stenosis (66.7%), uniformity of stenosis 23 (22.5%). CTVE showed complete occlusion of the trachea 11 (10.8%), including 2 for the eccentricity of stenosis at the FOB. 2 CTVE not show proliferative infiltration (6.4%). FOB CTVE found four changes not found in bronchial (3.8%). CTVE on EBTB detection rate was 85.2%, sensitivity was 92.3%, accuracy was 90.2%, specificity was 71.4%. CTVE comparison with fiberoptic bronchoscopy, p> 0.05, no significant difference. Conclusion CTVE and FOB check EBTB has a higher detection of consistent and complementary, and can be used as safe and simple means of diagnosis EBTB.