陈旧性肺结核复燃的CT征象分析

Analysis of CT features of old pulmonary tuberculosis recurrence

目的探讨陈旧性肺结核复燃患者的CT表现,为临床早期诊断提供依据。方法收集广州市胸科医院2009年4月至2019年12月经临床及实验室确诊的陈旧性肺结核患者100例,其中复燃患者40例为复燃组,无复燃患者60例为无复燃组,对比分析两组患者的CT特征,总结陈旧性肺结核复燃患者的CT征象。结果两组患者肺内病灶累及少于3个肺叶、多于3个肺叶、两肺各叶的发生率分别为22.50%(9/40)和65.00%(39/60)、60.00%(24/40)和25.00%(15/60)、17.50%(7/40)和10.00%(6/60),差异均有统计学意义(χ2值分别为17.37、12.36、5.32,P值分别为<0.0001、0.0004、0.0211)。两组患者肺内病灶在边缘清晰、钙化、肺门纵隔淋巴结肿大钙化及胸膜增厚等影像征象检出率方面比较,差异均无统计学意义(χ2值分别为2.025、3.255、0.0071、0.0631,P值分别为0.1548、0.0712、0.9330、0.8017),在支气管结核、合并实变及空洞、支气管扩张、肺大疱等影像征象检出率方面比较,差异均有统计学意义(χ2值分别为4.438、6.250、4.001、3.177,P值分别为0.0351、0.0124、0.0455、0.0015)。结论陈旧性肺结核复燃患者CT扫描肺内病变范围较广泛,肺内病变合并支气管结核、肺实变及空洞、支气管扩张及肺大疱的发生率较高,可为临床早期诊断与治疗提供一定的帮助。

Objective To investigate the CT features and charac-teristics of relapsing patients with old pulmonary tuberculosis,and to provide evidence for its early diagnosis.Methods A total of 100 patients with old pulmonary tuberculosis in Guangzhou Chest Hospital diagnosed by clinical and laboratory from April 2009 to December 2019 were collected,among which 40 patients with reburning were reburning group and 60 patients without reburning were nonreburning group.The CT features of the two groups were compared and analyzed,and the CT features of relapsing patients with old pulmonary tuberculosis were summarized.Results The incidence of pulmonary lesion involving lobes of both lungs in reburning group and nonreburning group was 22.50%(9/40)and 65.00%(39/60),60.00%(24/40)and 25.00%(15/60),17.50%(7/40)and 10.00%(6/60)22.50%(9/40),respectively.There were significantly difference between the two groups(χ2 values:17.37,12.36 and 5.32,respectively;P value:<0.0001,0.0004 and 0.0211,respectively).The detection rate of clear margin,calcification,hilar mediastinal lymph nodes and pleural thickening was compared between the two groups,there were no significant differences(χ2 values:2.025,3.255,0.0071 and 0.0631,respectively;P values:0.1548,0.0712,0.9330 and 0.8017,respectively).There were significantly difference in the detection rate of imaging signs of bronchial tuberculosis,consolidation and Cavitation,bronchiectasis,pulmonary bullae(χ2 values:4.438,6.250,4.001 and 3.177,respectively;P value:0.0351,0.0124,0.0455 and 0.0015,respectively).Conclusion CT scan of patients in the reburning group showed a wide range of pulmonary lesions,and the incidence of pulmonary lesions combined with bronchial tuberculosis consolidation,cavity bronchial dilatation and pulmonary bullae was higher than that in the nonreburning group,Which can make a contribution for early clinical diagnosis and treatment.