CT和传统X线诊断慢阻肺合并肺间质纤维化的诊断分析  

Diagnostic analysis of CT and traditional X-ray in the diagnosis of chronic obstructive pulmonary disease with pulmonary interstitial fibrosis

作　　者：于长锁 赵希瑶 YU Chang-suo;ZHAO Xi-yao(Radiology Department,Guangwai Hospital of Xicheng District,Beijing 100055,China)

机构地区：[1]北京市西城区广外医院放射科,100055

出　　处：《中国实用医药》2021年第11期50-52,共3页China Practical Medicine

摘　　要：目的探究CT和传统X线诊断慢性阻塞性肺疾病(慢阻肺)合并肺间质纤维化的诊断价值。方法 60例疑似慢阻肺合并肺间质纤维化患者,均开展CT和传统X线检查诊断,以肺组织病理学诊断作为金标准,分析CT和传统X线检查结果并比较诊断符合率、特异度、敏感度,观察记录慢阻肺合并肺间质纤维化传统X线、CT表现以及CT检查病灶分布情况。结果 60例疑似患者经肺组织病理学诊断,确诊为慢阻肺合并肺间质纤维化者有48例。CT、传统X线阳性检出率比较,差异无统计学意义(P>0.05)。CT诊断符合率88.3%、特异度83.3%、敏感度89.6%均高于58.3%、14.7%、62.5%,差异均具有统计学意义(P<0.05)。慢阻肺合并肺间质纤维化X线表现:患者的肺部纹理会出现紊乱、增强等表现,多数患者的肺部纹理还会出现弥漫性的分布,并呈现出网状、蜂窝状,此类现象的占比大约在83.33%,约有72.92%的患者会出现网织状的阴影,且边缘不清晰,并出现大小不一的结节状、小片状、点状等阴影。约有31.25%的患者会出现肺大泡;有14.58%的患者会出现支气管扩张现象,约有72.92%的患者会出现肺门阴影,且出现增大、结构紊乱等现象。慢阻肺合并肺间质纤维化CT表现为支气管的血管束会变细,且管壁出现增厚,血管束出现变形与扭曲,小叶内间质出现增厚,小叶间隔也出现增厚表现,胸膜出现下线,并出现磨玻璃影,有牵张性的支气管扩张现象,出现蜂窝状。结论慢阻肺合并肺间质纤维化诊断时, CT和传统X线均有一定的效果,但前者诊断符合率与敏感度均要优于后者,故临床应用价值较高,值得推荐。Objective To investigate the value of CT and traditional X-ray in the diagnosis of chronic obstructive pulmonary disease(COPD)with pulmonary interstitial fibrosis.Methods 60 cases of suspected chronic obstructive pulmonary disease patients with pulmonary interstitial fibrosis were diagnosed by CT and traditional X-ray examinations.Taking the lung histopathological diagnosis results as the gold standard,the results of CT and traditional X-ray examinations were analyzed,the diagnosis coincidence,specificity and sensitivity were compared,and the traditional X-ray and CT findings of chronic obstructive pulmonary disease with pulmonary interstitial fibrosis and the distribution of lesions on CT examination were observed and recorded.Results 60 suspected patients were diagnosed by lung histopathology,of which 48 cases were diagnosed as chronic obstructive pulmonary disease with pulmonary interstitial fibrosis.There was no statistically significant difference in the positive detection rate of CT and traditional X-ray(P>0.05).The diagnostic coincidence rate 88.3%,specificity 83.3%,sensitivity 89.6%of CT were higher than 58.3%,14.7%and 62.5%of traditional X-ray,and the difference was statistically significant(P<0.05).X-ray manifestations of chronic obstructive pulmonary disease with pulmonary interstitial fibrosis:the lung texture of patients would appear disordered and enhanced.In most patients,the lung texture would also appear diffusely and present a net-like and honeycomb-like appearance.The proportion of these phenomena was about 83.33%,and about 72.92%of patients would have reticulated shadows with unclear edges,and shadows such as nodules,small pieces,and dots of different sizes.About 31.25%of patients would develop bullae;14.58%of patients would develop bronchiectasis,and about 72.92%of patients would have the same hilar shadow,with enlargement and structural disorder.CT findings of chronic obstructive pulmonary disease with pulmonary interstitial fibrosis:the vascular bundles of the bronchial tubes would become t

关 键 词：CT 传统X线 诊断 慢性阻塞性肺合并肺间质纤维化 价值 

分 类 号：R563.9[医药卫生—呼吸系统]