86例耐多药肺结核患者胸部影像分析

Chest-imaging analysis of 86 cases of MDR-TB patients

目的探讨耐多药肺结核的胸部影像学特点。方法收集我院诊治的86例耐多药肺结核为观察组与96例不耐药肺结核患者为对照组,所有患者均行胸部CT和X线胸片检查。对病灶范围、空洞个数、空洞大小、洞壁厚度和纵隔淋巴结情况进行分析。结果两组在空洞大小方面差异无统计学意义,P>0.05;无空洞方面,观察组较对照组发生率低,P<0.005;观察组在累及3个以上肺野、毁损肺、空洞数量、厚壁空洞、纵隔淋巴结肿大方面发生率较高,P<0.005。结论耐多药肺结核以累及3个以上肺野、多发空洞、厚壁空洞、毁损肺、纵隔淋巴结肿大为主要影像学特点。

Objective To investigate the chest-imaging features of multidrug-resistant tuberculosis.Methods 86 cases of multidrug-resistant tuberculosis（MDR-TB） were categorized as group of observed,and 96 cases of drug-sensitive tuberculosis were categorized as control group,from January 2009 to December 2010,treating in our hospital.The scopes of lesions,the number and size of cavity,thick wall cavity and mediastinal lymph nodes were retrospectively analyzed.All patients were performed chest CT and X rays.Chi square test was used for statistical analysis.Results The sizes of cavity had no statistical differences in two groups.The study group in no cavity was less than the control group with statistically significant difference（P0.005）.The frequency of scopes of disease,destroyed lung,number of cavity,thick wall cavity,the mediastinum lymph nodes in study group were higher than those in control group with statistically significant difference（P0.005）.Conclusion More than three lung fields,multiple cavities,thick-walled cavities,destroyed lung,swelling mediastinum lymph nodes are main imaging features of multidrug-resistant tuberculosis.Mastering the imaging features of MDR-TB is conducive to the development of reasonable individualized treatment plan.