藏族青少年活动性肺结核治疗前后CT征象分析  

CT Signs of Tibetan Adolescents before and After Active Pulmonary Tuberculosis Treatment

作　　者：史永惠 段爱民 胡群英[2] 董建民[3] 王颖[4] 李绍林[5] SHI Yonghui;DUAN Aimin;HU Qunying(Department of Radiology,the Affiliated Hospital of Tibet Minzu University,Xianyang,Shanxi Province 712082,P.R.China)

机构地区：[1]西藏民族大学附属医院放射科,咸阳712082 [2]西藏民族大学医学院,咸阳712082 [3]西藏民族大学信息工程学院,咸阳712082 [4]中山大学附属第五医院核医学科,珠海519000 [5]中山大学附属第五医院放射科,珠海519000

出　　处：《临床放射学杂志》2020年第7期1307-1310,共4页Journal of Clinical Radiology

基　　金：西藏自治区自然科学基金资助项目(编号:XZ2017ZRG-58);广东省科技重点领域研发计划资助项目(编号:2018B030335001)。

摘　　要：目的探讨藏族青少年活动性肺结核高分辨率CT(HRCT)特征,分析HRCT在肺结核活动性诊断及疗效评估中的应用价值。方法选择2015年至2019年期间在西藏民族大学附属医院经临床、病理确诊为活动性肺结核的130例(15~19岁)藏族青少年作为研究对象,治疗前及治疗后均进行64排螺旋CT检查,分析活动性肺结核治疗前后的CT图像特征。结果藏族青少年活动性肺结核以多叶多段、双侧分布为主,肺部发病严重,以浸润性肺结核及空洞型肺结核多见,患病率随着年龄的增长而增加等临床特征。130例患者中治疗前CT共检出382处病灶。活动性肺结核CT征象包括肺实变、树芽征、小叶中央结节、磨玻璃影、空洞、烟花征、气道管壁增厚等。经规范治疗至少6个月后出现完全吸收58例,转为非活动性征象42例,残留为部分活动性征象30例。结论HRCT对肺结核的临床诊断准确性高,能准确判断肺结核疾病类型及评价治疗后的转归。熟悉藏族青少年肺结核病变的CT特点及不同类型肺结核CT图像特征,可提高诊断的准确性。Objective To investigate the signs of high resolution CT(HRCT)of active pulmonary tuberculosis in Tibetan adolescents,and analyze the application value of HRCT in the diagnosis and prognosis evaluation of active pulmonary tuberculosis.Methods 130 Tibetan teenagers aged 15 to 19 who were clinically and pathologically diagnosed with active tuberculosis in our hospital from 2015 to 2019 were selected as research subjects.64-slice spiral CT examination was conducted before and after treatment to analyze the CT image characteristics before and after treatment of active tuberculosis.Results Active pulmonary tuberculosis in Tibetan adolescents is mainly distributed in multiple lobes and segments,with bilateral distribution.The pulmonary incidence is severe,and infiltrative pulmonary tuberculosis and cavitation pulmonary tuberculosis are more common.Prevalence increased with age among the 130 patients.382 lesions were detected by CT before treatment.CT signs of active pulmonary tuberculosis include pulmonary consolidation,tree bud sign,centrilobular nodules,groundglass opacities,cavitation,fireworks sign,thickening of airway wall.After at least 6 months of standard treatment,58 cases had complete resorption,42 cases had non-active signs,and 30 cases had partially active signs.Conclusion HRCT has high accuracy in the clinical diagnosis of pulmonary tuberculosis.To be familiar with the CT features of pulmonary tuberculosis in Tibetan teenagers and the CT image features of different types of pulmonary tuberculosis,so as to improve the accuracy of diagnosis.

关 键 词：肺结核 螺旋CT 少数民族 

分 类 号：R521[医药卫生—内科学]