CT诊断成年囊性纤维化非结核性分枝杆菌感染的临床研究  

CT in diagnosis of cystic fibrosis of non-tuberculous mycobacteria infections in the adults

作　　者：蒋中灿[1] 刘巍[1] 刘奕[2] 

机构地区：[1]贵州省遵义县人民医院CT室,贵州遵义县563100 [2]贵州省人民医院影像中心,贵州贵阳563000

出　　处：《中华医院感染学杂志》2013年第17期4203-4205,共3页Chinese Journal of Nosocomiology

基　　金：贵阳市科技局一般支持项目(GK-2009B-034)

摘　　要：目的分析高分辨CT对成年囊性纤维化非结核性分枝杆菌（NTM）感染的诊断价值，以提髙成年囊性纤维化非结核性分枝杆菌感染的临床诊治水平。方法对医院2009年1月-2012年12月收治的100例成年囊性纤维化NTM感染患者进行高分辨CT检查与X线检查，比较CT检查结果与X线结果的异同，评价高分辨CT对成年囊性纤维化NTM感染的诊断价值;87例免疫功能正常患者根据病变部位将其分为典型组46例与非典型组41例，两组患者除发热外其他临床表现差异均无统计学意义。结果共调查3976例就诊患者，其中100例患者确诊为囊性纤维化NTM感染，感染率为2.52%;64例患者病变位于双侧肺部，73例位于右上叶，55例位于左上叶，36例位于右中叶，23例位于左舌叶，50例位于右下叶者，53例位于左下叶者；85例患者可见肺部空洞，内壁较粗糙，空洞直径为1-5 cm;部分患者可见肺气肿，纤维条索状阴影以及纵隔淋巴结肿大；54例患者出现肺部支气管扩张；CT比X线多检出13例，且空洞与结节检出数量多于X线平片；此外，CT还检出24例支气管扩张，19例树芽征。结论在疑似肺结核或痰液分枝杆菌检查阳性的患者中，若长期给予抗结核治疗无效或出现反复发作应考虑肺结核分枝杆菌感染，对此类患者给予高分辨CT检查能显著提高非结核分枝杆菌感染的临床检出率，提髙诊断准确性，对患者临床治疗具有重要的临床意义。OBJECTIVE To analyze the diagnostic value of high-resolution CT of adult cystic fibrosis non-tubercu-lous mycobacteria （NTM） infections so as to improve the level of clinical diagnosis and treatment of cystic fibrosisof non-tuberculous mycobacteria infections. METHODS The patients were treated in the hospital from Jan 2009 toDec 2012,100 adult patients with cystic fibrosis NTM infections were treated with high-resolution CT scan and X-ray examination. CT examination results and X-ray results were compared, and the diagnostic value of high-reso-lution CT of adult cystic fibrosis non-tuberculous mycobacterial infections was evaluated;87 cases of patients withnormal immune function,according to the lesions, were divided into the typical group （n = 46） and the atypicalgroup （n = 41） , all the difference clinical manifestations were not significant except for fever. RESULTS A total of3976 cases of patients were investigated in the study, including 100 patients diagnosed with cystic fibrosis non-tu-berculous mycobacteria, the infection rate was 2. 52%. Totally 64 cases of patients were with lesions located in bilateral lungs, 73 cases of patients with lesions located in the upper right lobe, 55 patients with lesions located inthe upper left lobe,36 cases of patients with lesions located in the right middle of tongue lesions located in the leftlobe, 50 cases with lesions located in the lower leaf,53 patients with, 23 cases with lesions located in the left lower lobe. Totally 85 patients were with visible lung cavities, with hole diameter of 1-5 cm; some of the patients visi-ble for emphysema, fiber funicular shadows and mediastinal lymph node enlargement. Totally 54 cases of patientswere with lung bronchiectasis;the CT detected 13 cases more than the X-ray did, and empty and nodules detectedmore by using CT than by using the X-ray plain film;in addition, CT detected 24 cases of bronchiectasis and 19 cases of tree-in-bud. CONCLUSION For the patients with suspected tuberculosis or the sputum cultured positive

关 键 词：高分辨CT 囊性纤维化 非结核性分枝杆菌 

分 类 号：R181.32[医药卫生—流行病学]