59例初治菌阴活动性肺结核患者的MSCT表现分析  

Analysis of the MSCT manifestations of 59 cases of initially treated active pulmonary tuberculosis with bacteria-negative

作　　者：杨登法[1] 杨铁军 叶啸 华浅近[1] 丁力 王林友[1] 杨亦德 YANG Dengfa;YANG Tiejun;YE Xiao;HUA Qianjin;DING Li;WANG Linyou;YANG Yide(Department of Radiology,Taizhou Municipal Hospital,Taizhou 318000,China;Department of Infectious Diseases,Taizhou Municipal Hospital,Taizhou 318000,China)

机构地区：[1]浙江省台州市立医院放射科,浙江台州318000 [2]浙江省台州市立医院感染科,浙江台州318000

出　　处：《中国现代医生》2021年第14期123-126,130,共5页China Modern Doctor

基　　金：浙江省医药卫生科研基金资助项目(2019KY784;2019KY787)。

摘　　要：目的探讨初治菌阴活动性肺结核患者的MSCT表现,提高对该病的认识。方法搜集2016年1月至2019年10月在我院登记治疗、资料完整的初治菌阴活动性肺结核患者59例,由2名胸部影像专家阅片,分析、记录该病胸部MSCT表现特点。结果59例菌阴活动性肺结核患者经过6个月正规药物治疗后均有吸收好转。59例菌阴活动性肺结核患者中,男40例,女19例,年龄16~68岁,平均年龄33.2岁。肺部病变累及两肺上叶为主,其中两肺上叶同时受累15例,仅左肺上叶受累16例,仅右肺上叶受累11例。两肺下叶受累8例,两肺上下叶受累6例,两肺弥漫受累3例。初治菌阴活动性肺结核MSCT征象中,小叶中心结节55例,腺泡结节50例,树芽征47例,小叶样实变28例,磨玻璃影26例,边缘模糊的实变18例,支气管壁增厚15例,厚壁空洞9例,多发结节内小空洞3例,上述征象检出率分别为93.2%、84.7%、79.7%、47.5%、44.1%、30.5%、25.4%、15.3%、5.08%。非活动性肺结核MSCT征象中,斑块16例,边缘清晰高密度结节15例,条索影14例,钙化14例,支气管扩张3例,肺结构扭曲变形2例,上述征象检出率分别为27.1%、25.4%、23.7%、23.7%、5.09%、3.39%。结论小叶中心结节,腺泡结节,树芽征是初治菌阴活动性肺结核MSCT最常见征象,代表结核杆菌易支气管播散特点。结合病灶部位、形态可以提高菌阴活动性肺结核诊断的准确率。Objective To investigate the MSCT manifestations of initially treated active pulmonary tuberculosis with bacteria-negative and improve the disease's understanding.Methods A total of 59 cases of initially treated active pulmonary tuberculosis with bacteria-negative who had complete data in our hospital from January 2016 to October 2019 were collected.Two chest imaging experts read the pictures,analyzed and recorded the chest MSCT features of the disease.Results Fifty-nine cases of active pulmonary tuberculosis with bacteria-negative were absorbed better after six months of regular drug treatment.Among them,40 were males,and 19 were females,aged 16-68 years,with an average age of 33.2 years.Lung lesions mainly affected the upper lobes of the two lungs,of which 15 cases of upper lobes of both lungs were simultaneously affected,only the left upper lobe was affected in 16 cases,and only the right upper lobe was affected in 11 cases.There were 8 cases of affected lower lobes of both lungs,6 cases of affected upper and lower lobes of both lungs,and 3 cases of diffuse involvement of both lungs.Among the MSCT signs of initially treated active pulmonary tuberculosis with negative bacteria,there were 55 cases of central lobular nodules,50 cases of acinar nodules,47 cases of tree bud sign,28 cases of lobular consolidation,26 cases of ground glass shadow,and 18 cases of consolidation with fuzzy edges,15 cases of bronchial wall thickening,9 cases of thick-walled cavities,and 3 cases of multiple small cavities within nodules.The detection rates of the above signs were 93.2%,84.7%,79.7%,47.5%,44.1%,30.5%,25.4.%,15.3%,and 5.08%.Among the MSCT signs of inactive pulmonary tuberculosis,16 cases were plaques,15 cases were high-density nodules with clear edges,14 cases were streak shadow,14 cases were calcification,3 cases were bronchiectasis,and 2 cases were distorted and deformed lung structure.The detection rates of the above signs were 27.1%,25.4%,23.7%,23.7%,5.09%,and 3.39%respectively.Conclusion Central lobular nodules,acinar no

关 键 词：肺结核 菌阴 体层摄影术 X线计算机 

分 类 号：R445.3[医药卫生—影像医学与核医学]