新发与复发活动性肺结核CT影像对比分析

Contrast research about active CT imaging in newly and relapsed pulmonary tuberculosis

目的:探讨新发与复发活动性肺结核的CT影像特征。方法:收集2006～2008年住院治疗的新发与复发肺结核患者各100例,对比观察两组CT征象的异同点以诊断活动性肺结核有价值的征象。结果:小叶中心结节、磨玻璃影、树芽征、空洞征、小叶样实变、亚段以上实变,新发组及复发组CT检出率依次为:86%/81%、75%/65%、66%/59%、37%/33%、66%/55%、28%/35%,纤维条索影、支气管扩张、肺气肿、钙化两组为6%/52%、12%/35%、9%/28%、10%/35%;小叶中心结节、磨玻璃影、树芽征、空洞征、小叶样实变、亚段以上实变的检出率在新发与复发病例间比较,差异无统计学意义(P>0.05),纤维条索影、支气管扩张、肺气肿、钙化的检出率在新发与复发病例间比较,差异有统计学意义(P<0.05)。结论:小叶中心结节、磨玻璃影、树芽征、空洞征、小叶样实变、亚段以上实变为共同征象,作为CT活动性征象,而纤维条索影、支气管扩张、肺气肿、钙化为不同征象,作为CT非活动性征象。CT活动性征象有助于活动性肺结核的诊断,但尚需结合临床和痰检检查。

Objective： To explore CT imaging characteristics in newly and relapsed of active pulmonary tuberculosis.Methods： 100 patients with newly and the other 100 patients with relapsed who were inpatient from 2006 to 2008 were scanned by CT examination.Then the differences of CT imaging and its occurrence between the two groups were observed.Results： The contrast of CT occurrence between newly and relapsed group showed that the occurrence of lobular nodules,ground-glass opacity,tree-in-bud sign,cavity,lobular consolidation as well as segmental and subsegmental consolidation were 86%/81%,75%/65%,66%/59%,37%/33%,66%/55%,28%/35% respectively,there was no significant difference（P0.05）.And the differences in the fiber rope band,bronchiectasis,emphysema,calcify between newly and relapsed were significant difference（P0.05）,and the occurrence were 6%/52%,12%/35%,9%/28%,10%/35% respectively.Conclusion： Active CT imaging,lobular nodules,ground-glass opacity,tree-in-bud sign,cavity,lobular consolidation and subsegmental consolidation;inactive CT imaging,fiber rope band,bronchiectasis,emphysema,calcify.Active CT imaging is helpful to their differential diagnosis,while carefully considering the clinical symptoms and sputum examinations at the same time.