肺结核合并肺炎患者结节或肿块的CT表现与鉴别诊断研究

CT Features and Differential Diagnosis of Tubercle or Mass in Tuberculosis Patients with Pneumonia

目的探讨肺结核合并肺炎患者结节或肿块的CT表现与鉴别诊断。方法本研究涉及对象为98例肺结核合并肺炎患者,病例选取时间为2015年3月至2018年2月,均行CT平扫与CT增强扫描,以手术病理诊断结果为金标准,对比两种不同诊断方法准确率,分析结节或者肿块的CT表现,使用统计学进行分析。结果与CT平扫相比,CT增强扫描的诊断准确率明显更高,P<0.05。肺结核合并肺炎患者与肺癌患者的斑片条索影、钙化、结节影、空泡影、空腔或者空洞的检出率比较,组间无统计学差异(P>0.05)。肺结核合并肺炎患者与肺癌患者的分叶征、毛刺征、胸膜凹陷征、棘状突起比较,组间有统计学差异(P<0.05)。肺结核合并肺炎患者与肺癌患者的强化均匀、周边强化、广泛强化比较,组间有统计学差异(χ^(2)=42.1822、6.8929、8.2947,均P<0.05);肺结核合并肺炎患者与肺癌患者的强化不均比较,组间无统计学差异(χ^(2)=1.1014,P>0.05)。结论肺结核合并肺炎患者使用CT扫查可见结节或者肿块呈高密度影,极易与肺癌混淆,增强扫描可有效鉴别两种疾病。

Objective To investigate the CT findings and differential diagnosis of tubercle or mass in pulmonary tuberculosis patients with pneumonia.Methods Ninety-eight cases of pulmonary tuberculosis combined with pneumonia were studied in this study.The time of case selection was from March 2015 to February 2018.Both CT scan and CT enhanced scan were performed.The results of surgical pathological diagnosis were gold standards,and the accuracy of the two different diagnostic methods was compared,P<0.05,Analyze CT findings of nodules or masses and use statistics to analyze them.Results The diagnostic accuracy of CT scan was higher than that of CT scan,P<0.05.Compared to the detection rate of patch shadow,calcification,nodule shadow,empty bubble,cavity or cavity in patients with tuberculosis combined with pneumonia and lung cancer,no statistical difference between groups(P>0.05),comparable.Comparison of leaves,bristles,pleural recesses,and spines in patients with tuberculosis combined with pneumonia and lung cancer,there are statistical differences between groups(P<0.05).The reinforcement of pulmonary tuberculosis patients with pneumonia and lung cancer patients was uniform,peripheral reinforcement,and extensive reinforcement,there are statistical differences between groups(χ^(2)=42.1822,6.8929,8.2947,all P<0.05).The contrast between pulmonary tuberculosis patients with pneumonia and lung cancer patients is uneven,no statistical difference between groups(χ^(2)=1.1014,P>0.05).Conclusion The CT scan of pulmonary tuberculosis patients with pneumonia showed a high density of nodules or lumps,which is easily confused with lung cancer.Enhanced scanning can effectively identify the two diseases.