螺旋CT联合胸部X线在早期肺部感染诊断中的应用

Application of spiral CT combined with chest X-ray in early diagnosis of pulmonary infection

目的探讨早期肺部感染诊断中采用螺旋CT和胸部X线联合检查的效果.方法选取2016年5月至2018年8月在佳木斯中心医院就诊的疑似肺部感染患者98例,均行螺旋CT、胸部X线检查.以痰培养结果为对照,对比胸部X线检查和螺旋CT联合胸部X线检查的诊断结果及价值,分析螺旋CT诊断不同感染类型患者影像学征象.结果经痰培养确诊,98例疑似患者中肺部感染阳性52例,阴性46例.螺旋CT联合胸部X线检查肺部感染的准确性明显高于胸部X线检查,差异有统计学意义(P<0.05);肺部感染诊断中螺旋CT胸部X线联合检查的诊断价值(阳性预测值、敏感性、阴性预测值、特异性)均高于单纯胸部X线检查,差异有统计学意义(P<0.05);经痰培养发现,52例肺部感染患者中混合感染17例,非特异性细菌感染19例,病毒感染4例,真菌感染12例.在CT影像学征象中,病毒感染以磨玻璃为主,真菌感染中可见实变影、结节影及磨玻璃影,非特异性细菌感染以实变影为主,混合感染以实变影、磨玻璃影为主.结论螺旋CT联合胸部X线检查诊断早期肺部感染具有较高的诊断价值,可进一步辨别感染类型,为治疗方案的制定提供依据.

Objective To investigate the effect of spiral CT combined with chest X-ray on diagnosis of early pulmonary infection.Methods Ninety-eight patients suspected with pulmonary infection from May 2016 to August 2018 in the Central Hospital of Jiamusi were selected,and all underwent spiral CT and chest X-ray.Compared with sputum culture results,the diagnostic results and value of chest X-ray examination and spiral CT combined with chest X-ray examination were compared,and the imaging signs of spiral CT in diagnosis of patients with different types of infection were analyzed.Results Among the 98 suspected cases,52 cases were positive for pulmonary infection and 46 cases were negative.The accuracy of spiral CT combined with chest X-ray examination for pulmonary infection was significantly higher than that of chest X-ray examination(P<0.05).The diagnostic value of spiral CT combined with chest X-ray examination(positive predictive value,sensitivity,negative predictive value,specificity)in the diagnosis of pulmonary infection was higher than that of pure chest X-ray examination(P<0.05).According to sputum culture,among 52 patients with pulmonary infection,17 cases had mixed infection,19 cases had non-specific bacterial infection,4 cases had viral infection and 12 cases had fungal infection.Among CT imaging signs,ground glass was the main type of virus infection;consolidation,nodule and ground glass were visible in fungal infections,consolidation was the main type of non-specific bacterial infections;and consolidation and ground glass were the main types of mixed infections.Conclusions Spiral CT combined with chest X-ray examination is of high diagnostic value in the diagnosis of early pulmonary infection,which can further identify the types of infection and provide a basis for the development of treatment programs.