肺结核影像诊断标准

Imaging diagnostic criteria for pulmonary tuberculosis

肺结核(pulmonary tuberculosis,PTB)是由结核分枝杆菌感染引起的严重危害人类健康的肺部慢性传染病,是世界公认的重大公共卫生问题,也是全球十大死亡原因之一。早期精准诊断有助于减少肺结核的传播并降低患者发病率和病死率,因而制订肺结核影像学诊断标准意义重大。本标准基于循证医学指南及标准制定的方法学,参照2011年牛津大学循证医学中心证据分级标准和国际评估、发展和评价分级(Grades of Recommendations Assessment,Development and Evaluate,GRADE)工作组推荐意见形成的方法学,并根据2017年11月9日国家卫生和计划生育委员会发布的肺结核诊断标准,最终形成推荐意见,包括原发性肺结核、血行播散性肺结核、继发性肺结核、气管支气管结核、结核性胸膜炎的影像表现、疑似病例、影像诊断病例、确诊病例诊断标准及影像学鉴别诊断等,为肺结核的临床影像诊断和鉴别诊断提供科学依据。

Pulmonary tuberculosis is a chronic contagious disease caused by the infection of mycobacterium tuberculosis.It is recognized as a major public health problem and one of the top ten causes of death worldwide.Early accurate diagnosis is the key to reduce the spread of pulmonary tuberculosis and lower the incidence and mortality.Therefore,it is of great significance to establish a set of imaging diagnostic criteria for tuberculosis.Based on the methodology formulated by evidence-based medicine guidelines and standards,this standard has been referred to the 2011 evidence grading standards of evidence-based medicine center of Oxford University and the methodology formulated by the working group recommendation of international grading of Recommendations Assessment,Development and Evaluation(GRADE).Collectively,the final recommendation was formulated according to the tuberculosis diagnostic standards issued by the National Health and Family Planning Commission on November 9th,2017.This standard covers the imaging manifestations,suspected cases,imaging diagnostic cases,diagnostic criteria and imaging differential diagnosis of primary pulmonary tuberculosis,hematogenous disseminated pulmonary tuberculosis,secondary pulmonary tuberculosis,tracheobronchial tuberculosis and tuberculous pleurisy,providing scientific evidence for the clinical imaging diagnosis and differential diagnosis of pulmonary tuberculosis.