肺结核合并肺炎患者的CT表现与诊断分析

Analysis of CT Findings and Diagnosis of Pulmonary Tuberculosis Complicated With Pneumonia

目的探讨肺结核合并肺炎患者的CT表现与诊断效果。方法将本院收治的200例肺结核合并肺炎患者(2015年1月-2017年12月)纳入研究,对所有患者均实施CT检查,并将内镜检查结果作为标准,分析检查效果。结果患者实施CT增强扫描对斑片条索影、钙化、毛刺征、结节影、棘状突起、空泡影、分叶征检出率94.0%、89.0%、30.0%、65.0%、38.0%、42.0%、25.0%,与CT平扫结果90.0%、84.0%、25.0%、60.0%、35.0%、40.0%、24.0%相比无明显差异(χ^2=2.174,P=0.140;χ^2=2.141,P=0.143;χ^2=1.254,P=0.263;χ^2=1.067,P=0.302;χ^2=0.388,P=0.533;χ^2=0.165,P=0.684;χ^2=0.541,P=0.816)。但实施CT增强扫描对肺结核合并肺炎的检出率91.0%与CT平扫97.0%相比更高(χ^2=6.383,P=0.012)。实施CT增强扫描时确诊患者中广泛强化发生率59.3%与误诊患者16.7%对比更高(χ^2=4.338,P=0.037);确诊患者周边强化发生率20.6%与误诊患者66.7%对比更低(χ^2=7.192,P=0.007)。结论肺结核合并肺炎患者实施CT增强扫描效果优于CT平扫,且通过CT检查对肺结核合并肺炎患者诊断效果良好。

Objective To investigate the CT findings and diagnostic effects of patients with pulmonary tuberculosis complicated with pneumonia.Methods 200 patients of pulmonary tuberculosis complicated with pneumonia admitted from our hospital(from January 2015 to December 2017) were enrolled in the study. CT examination was performed on all patients, and the results of endoscopy were used as criteria to analyze the effect. Results Patients underwent CT-enhanced scanning on the detection of patch, calcification, burr, nodule, spinous process, empty bubble, and lobulation. The detection rates were 94.0%, 89.0%, 30.0%, 65.0%, 38.0%, 42.0%, 25.0% and CT scan results were 90.0%, 84.0%, 25.0%, 60.0%, 35.0%, 40.0%, 24.0%, no significant difference( χ^2=2.174, P =0.140;χ^2= 2.141, P =0.143;χ^2=1.254, P =0.263;χ^2=1.067, P =0.302;χ^2=0.388, P=0.533;χ^2=0.165, P =0.684;χ^2=0.541, P =0.816). However, the detection rate of tuberculosis complicated with pneumonia by CT-enhanced scan was 91.0% higher than that of CT scan 97.0%(χ^2=6.383, P=0.012). The incidence of extensive intensification in patients diagnosed with CT-enhanced scan was 59.3% higher than that of misdiagnosed patients(16.7%, χ^2=4.338, P=0.037);the incidence of peripheral enhancement in confirmed patients was 20.6% lower than of misdiagnosed patients(66.7%, χ^2=7.192, P=0.007). Conclusion The CT-enhanced scan of patients with pulmonary tuberculosis complicated with pneumonia is better than that of CT scan, and the diagnosis of pulmonary tuberculosis complicated with pneumonia by CT examination is good.