多层螺旋CT和直接数字成像系统诊断不同类型肺结核的价值  

Diagnostic value of multislice spiral CT and DDR in patients with different types of tuberculosis

作　　者：梁斌 孙井松 陈慧红 李雄 林波淼[2] LIANG Bin;SUN Jingsong;CHEN Huihong;LI Xiong;LIN Bomiao(Department of Radiology,Affiliated Shunde Hospital of Guangzhou Medical University,Foshan 528315,China;Department of Imaging,Zhujiang Hospital of Southern Medical University,Guangzhou 510280,China)

机构地区：[1]广州医科大学附属顺德医院(佛山市顺德区乐从医院)放射科,广东佛山528315 [2]南方医科大学珠江医院影像诊断科,广东广州510280

出　　处：《分子影像学杂志》2020年第3期428-433,共6页Journal of Molecular Imaging

基　　金：广东省医学科学技术研究基金项目(C2017041)。

摘　　要：目的探讨多层螺旋CT(MSCT)、直接数字成像系统(DDR)诊断活动性肺结核(ATB)、非ATB的价值。方法选择2018年2月~2019年10月我院收治的80例肺结核患者,其中ATB 39例、非ATB 41例,均行MSCT和DDR检查。观察ATB、非ATB患者DDR和MSCT征象特征,以病理结果为准,利用受者工作特征曲线分析MSCT、DDR、DDR+MSCT对肺结核诊断价值。结果 DDR肺结核检出率65.00%,ATB组片状、边缘不清、密度不匀致密阴影检出率高于非ATB组(P<0.05)。MSCT肺结核检出率76.25%,ATB组MSCT征象以磨玻璃密阴影,结节,树芽征,支气管壁增厚,边缘模糊实变,空洞为主,非ATB组MSCT征象以高密度结节,条索影,肺结构扭曲为主。以病理结果为准,DDR、MSCT、DDR+MSCT诊断ATB的灵敏度为64.10%、84.62%、92.31%,特异度为65.85%、68.29%、87.80%,AUC为0.638、0.752、0.888,DDR+MSCT诊断AUC高于单独DDR、MSCT(P<0.05)。结论 MSCT、DDR诊断肺结核均有一定价值,DDR+MSCT可提高对肺结核检出率以及ATB鉴别诊断价值。Objective To explore the diagnostic value of multi-slice spiral CT(MSCT) and direct digital radiography(DDR) in active pulmonary tuberculosis(ATB) and non-active pulmonary tuberculosis(non-ATB). Methods From February 2018 to October 2019, 80 cases of tuberculosis in our hospital were admitted, including 39 cases of ATB and 41 cases of non-ATB. All patients were examined by MSCT and DDR. The DDR and MSCT features of ATB and non-ATB patients were observed. The diagnostic value of MSCT, DDR and DDR+MSCT were analyzed by receiver operator characteristics curve(ROC)based on the pathological results. Results The detection rate of pulmonary tuberculosis by DDR was 65.00%. The detection rate of patchy,indistinct edge and unevenly dense shadow in ATB group were higher than that in non-ATB group(P<0.05). Pulmonary tuberculosis detection rate was 76.25% by MSCT. The MSCT signs in group ATB were to give priority to ground glass density shadow, nodules, tree bud sign, thickening of bronchial wall, fuzzy consolidation at the edge, mainly cavity, while the MSCT signs in group non-ATB were high-density nodules, stripe shadow and lung structure distortion. According to the pathological results, the sensitivity and specificity of DDR, MSCT and DDR+MSCT in diagnosing ATB were 64.10%, 84.62%,92.31%;65.85%,68.29%, 87.80%, respectively, and the AUC was 0.638, 0.752, 0.888, respectively. Conclusion MSCT and DDR have certain value in diagnosing pulmonary tuberculosis. DDR+MSCT can improve the detection rate of pulmonary tuberculosis and the value of ATB differential diagnosis.

关 键 词：多层螺旋CT 直接数字成像 肺结核 活动性肺结核 非活动性结核 诊断价值 

分 类 号：R521[医药卫生—内科学] R816.41[医药卫生—临床医学]