老年Ⅲ期尘肺与结节状大阴影继发性肺结核的高分辨率CT鉴别诊断  

Differential diagnosis of stage Ⅲ pneumoconiosis and secondary tuberculosis with large nodular shadow using high resolution CT in the elderly

作　　者：张敬华[1] 程钢[1] 杨燕英[1] 霍萍萍 ZHANG Jing-Hua;CHENG Gang;YANG Yan-Ying;HUO Ping-Ping(Department of Radiology,Beijing Geriatric Hospital,Beijing 100095,China;Clinical Laboratory,Beijing Geriatric Hospital,Beijing 100095,China)

机构地区：[1]北京老年医院放射科,北京100095 [2]北京老年医院检验科,北京100095

出　　处：《中华老年多器官疾病杂志》2020年第10期745-748,共4页Chinese Journal of Multiple Organ Diseases in the Elderly

基　　金：北京市医院管理局临床医学发展专项(ZYLX201834)。

摘　　要：目的分析老年Ⅲ期尘肺与结节状大阴影继发性肺结核的高分辨率CT(HRCT)鉴别诊断要点,提高老年Ⅲ期尘肺诊断准确率。方法回顾性分析老年Ⅲ期尘肺患者43例和老年结节状大阴影肺结核患者55例,对2组患者的一般资料及影像征象进行比较。应用SPSS 22.0软件进行统计学分析。结果2组患者临床表现中性别、咯血、胸痛、喘憋、呼吸困难等5个因素组间差异有统计学意义(P<0.05)。2组患者CT征象中大阴影发生在双肺上叶、左肺上叶、大阴影内钙化、空洞、大阴影周边肺气肿、肺内粟粒影、支气管扩张、肺门淋巴结肿大、肺门淋巴结钙化及纵隔淋巴结钙化等10个因素组间差异有统计学意义(P<0.05)。结论老年Ⅲ期尘肺患者的HRCT具有一定的特征性,结合其临床表现可提高其诊断准确率。Objective To analyze the key points of differential diagnosis between stageⅢpneumoconiosis and secondary tuberculosis with large nodular shadow using high-resolution CT(HRCT)in the elderly with a view to improving the diagnostic accuracy of stageⅢpneumoconiosis in the elderly.Methods A retrospective analysis was made of 43 cases of stageⅢpneumoconiosis and 55 cases of secondary tuberculosis with large nodular shadow in the elderly.The two groups were compared in their general information and imaging characteristics.Statistical analysis was performed using SPSS statistics 22.0.Results As for clinical manifestations,there were significant differences between the two groups in five factors:gender,hemoptysis,chest pain,wheeze,and dyspnea(P<0.05).As for CT features,there were significant differences between the two groups in 10 factors:bilateral upper lobes,upper left lobe,calcification in the big shadow,cavity,emphysema around the big shadow,miliary shadow in the lung,bronchiectasis,hilar lymph node enlargement,hilar lymph node calcification and calcification of mediastinal lymph nodes(P<0.05).Conclusions HRCT shows specificity of some degree for stageⅢpneumoconiosis in the elderly,which can improve the diagnostic accuracy if combined with the clinical manifestations.

关 键 词：老年人 Ⅲ期尘肺 肺结核 体层摄影术 X线计算机 

分 类 号：R814.42[医药卫生—影像医学与核医学]