艾滋病合并肺结核中的CT影像学特征和诊断价值分析

Analysis of CT Imaging Features and Diagnostic Value in AIDS Complicated with Pulmonary Tuberculosis

目的探讨艾滋病合并肺结核患者行胸部CT检查的影像学特征及其在疾病诊断上的价值。方法选取本院在2018年3月至2019年4月诊治的40例艾滋病合并肺结核患者作为观察组,同时选择同期入院诊治40例单纯肺结核患者作为对照组。给予两组胸部CT检查,分析影像学特征,并探讨其诊断价值。结果与对照组比较,观察组淋巴结或胸膜受累所占比较明显更高,差异有统计学意义(P<0.05);与综合检查诊断结果比较,胸部CT检查继发性肺结核、血行播散型肺结核诊断准确率分别为96.55%、91.67%,漏诊2例(5.00%);艾滋病伴肺结核患者接受胸部CT检查时,影像学特征主要表现为双肺肺叶、肺段可见明显渗出性病变,肺内纤维索条影显示明显,同时还呈现明显空洞影、斑片状影,伴有明显腋窝、纵隔淋巴结肿大及心包、胸腔积液等情况。结论胸部CT检查方式用于艾滋病伴肺结核患者诊断,能够获得明显影像学特征,有助于诊断准确率提高。

Objective To explore the imaging characteristics of chest CT in AIDS patients with pulmonary tuberculosis and its diagnostic value. Methods 40 HIV patients with Tuberculosis who were diagnosed and treated in our hospital from March 2018 to April 2019 were selected as the observation group, while 40 HIV patients with Tuberculosis who were diagnosed and treated in the same period were selected as the control group. Two groups were given chest CT examinations,the imaging characteristics were analyzed, and the diagnostic value was explored. Results The proportion of lymph node or pleural involvement was significantly higher in the observation group compared with the control group(P<0.05);Compared with the diagnostic results of comprehensive examination, the diagnostic accuracy of chest CT examination for secondary pulmonary tuberculosis and hematogenous disseminated pulmonary tuberculosis were 96.55%, 91.67%, and 2 cases(5.00%) were missed. When AIDS patients with pulmonary tuberculosis underwent chest CT examination, the imaging features were mainly bilateral pulmonary lobes and segments with obvious exudative lesions, and obvious fibrous stripes and patchy shadows in the lungs, while also presenting cavity shadow,accompanied by pleural effusion, axillary lymph node enlargement, mediastinal lymph node enlargement and pericardial effusion. Conclusion Chest CT examination of AIDS patients with pulmonary tuberculosis can show obvious imaging characteristics and obtain a higher diagnostic accuracy.