140例非结核分枝杆菌肺病的计算机体层成像征象分析

Comparison of CT Imaging Characteristics of 140 Cases of Non-Tuberculous Mycobacterium Lung Disease

目的:通过对比研究胞内分枝杆菌、堪萨斯分枝杆菌、龟/脓肿分枝杆菌肺病患者的胸部计算机体层成像(CT)表现,探讨不同菌种非结核分枝杆菌肺病的CT征象差异。方法:回顾性分析2015年10月~2019年11月天津市海河医院确诊的非结核分枝杆菌肺病患者140例(包括经临床及实验室证实的60例胞内分枝杆菌、40例堪萨斯分枝杆菌、40例龟/脓肿分枝杆菌肺病患者)胸部CT表现,对比其差异性。结果:胞内分枝杆菌肺病患者比堪萨斯分枝杆菌肺病患者更容易出现肺实变、右肺中叶、左肺上叶舌段支气管扩张、纵隔肿大淋巴结;与胞内分枝杆菌肺病患者相比堪萨斯分枝杆菌肺病患者更容易出现右肺上叶空洞;堪萨斯分枝杆菌肺病患者与龟/脓肿分枝杆菌肺病患者比较更容易出现右肺上叶空洞以及右肺中叶、左肺上叶舌段的支气管扩张;胞内分枝杆菌肺病患者相对于龟/脓肿分枝杆菌肺病患者来说肺实变、右肺上下叶空洞、右肺中上叶及左肺上叶舌段支气管扩张、纵隔肿大淋巴结的出现概率要更高。结论:相对于龟/脓肿分枝杆菌肺病患者而言,胞内分枝杆菌肺病、堪萨斯分支杆菌肺病患者的CT表现具有一定的特异性。

Objective:To compare the chest computed tomography(CT)findings of Mycobacterium intracellular,Mycobacterium kansasii and Mycobacterium chelonis/abscessus lung disease patients,and to explore the difference of CT findings of different strains of non-tuberculous mycobacterium lung disease.Methods:From October 2015 to November 2019,140 patients with non-tuberculous mycobacterium lung disease confirmed in Tianjin Haihe Hospital(including 60 cases of Mycobacterium intracellulare,40 cases of Mycobacterium kansasii,40 cases of Mycobacterium chelonei/abscessus lung disease confirmed by clinical and laboratory)were retrospectively analyzed and compared with the chest CT findings.Results:The patients with Mycobacterium intracellular lung disease were more likely to have lung consolidation,bronchiectasis of right middle lobe and left upper tongue segment,and enlarged mediastinal lymph nodes than those with Mycobacterium kansasii lung disease.Patients with Mycobacterium kansasii lung disease were more likely to have right upper lobe cavities than patients with Mycobacterium intracellulare lung disease;Patients with Mycobacterium kansasii lung disease were more likely to develop right upper lobe cavity and bronchiectasis in right middle lobe and left upper lobe tongue segment than those with Mycobacterium chelonei/abscessus lung disease.Patients with Mycobacterium intracellulare lung disease were more likely to have lung consolidation,cavity in the upper and lower lobes of the right lung,bronchiectasis in the middle and upper lobes of the right lung,and enlarged lymph nodes in the mediastinum than patients with Mycobacterium chelonei/abscessus lung disease.Conclusion:Compared with the patients with Mycobacterium chelonei/abscessus lung disease,the CT findings of Mycobacterium intracellulare lung disease and Mycobacterium kansasii lung disease have certain specificity.