耐多药肺结核的影像特点

The imaging feature of multidrug-resistant tuberculosis

目的 搜集经药物敏感试验证实的耐多药肺结核 ,探讨耐药肺结核的影像学特点。方法 选取耐多药肺结核 51例为观察组 ,同期不耐药的肺结核病人 46例为对照组。全部病人均有正、侧位胸片 ,部分病人有同期体层或CT片。结果 (1)观察组与对照组相比 ,病变分布差异无显著性意义 (P值均 >0 .0 5)。 (2 )比较病变形态 ,观察组肺内多发结节 (10例 )、播散病灶 (2 3例 )、空腔(9例 )及合并肺毁损 (10例 )多于对照组 ,二者差异有显著性意义 (P <0 0 5)。 (3 )病变的动态变化 ,病变进展观察组多于对照组 ,好转病例观察组少于对照组 ,二者差异有显著性意义 (P <0 0 5)。结论 分析耐多药肺结核的影像表现提示 ,耐多药肺结核具有病变严重 ,活动性明显 。

Objective To evaluate the imaging features of multidrug-resistant tuberculosis by collecting multidrug-resistant tuberculosis verified by test of drug-sensitivity,which defined as resistance to three anti-tuberculosis drugs Methods Fifty-one cases of multidrug-resistant tuberculosis were categorized as group of observed,and 46 cases of drug sensitive tuberculosis were categorized as control Cultures were positive for Mycobacterium tuberculosis in all cases with no other illness such as diabetes mellitus All patients had chest radiographs available for review,while 64 cases had tomography and 30 cases had CT during the same time All images were analyzed by three of the radiologists,disagreement among them was discussed and a consensus was reached Results There was no difference in the distribution of lesions between the multidrug-resistant tuberculosis group and control group However,the radiological findings in the multidrug-resistant tuberculosis group were significantly more common than in control group,such as multiple nodules (10 cases),disseminated foci (23 cases),cavity (9 cases),and complications (10 cases). Comparing the dynamic cases,deteriorating cases were more commonly seen in observed group than in control group,while improved cases were less in observed group than in control group Conclusion Multidrug-resistant tuberculosis is the most serious tuberculosis,which is characterized with significant activity,more disseminated foci,cavity,and complications The lesion deteriorated while correct anti-tuberculosis treatment is applied