堪萨斯分枝杆菌肺病与耐药性肺结核的CT影像特征比较  

Comparison of CT Imaging Characteristics of Mycobacterium Kansasii Pulmonary Disease and Drug-Resistant Pulmonary Tuberculosis

作　　者：杨晴媛 乔杰 邢志珩[1,2,3] Yang Qingyuan;Qiao Jie;Xing Zhiheng(Tianjin Haihe Hospital,Tianjin 300350,China;Tianjin Institute of Respiratory Diseases,Tianjin 300350,China;TCM Key Research Laboratory for Infectious Disease Prevention for State Administration of Traditional Chinese Medicine,Tianjin 300350,China;Tianjin First Central Hospital,Tianjin 300192,China)

机构地区：[1]天津市海河医院,天津300350 [2]天津市呼吸疾病研究所,天津300350 [3]国家中医药管理局中医药防治传染病重点研究室,天津300350 [4]天津市第一中心医院,天津300192

出　　处：《医疗装备》2022年第7期5-8,14,共5页Medical Equipment

摘　　要：目的比较堪萨斯分枝杆菌肺病与耐药性肺结核的CT影像特征,以提高鉴别诊断水平。方法回顾性分析天津市海河医院2015年1月至2019年10月确诊的40例堪萨斯分枝杆菌肺病和40例耐药性肺结核患者的临床及影像资料,比较两种疾病的CT影像特征。结果确诊后首诊CT时,两种疾病的影像特征均呈双肺多叶广泛分布,堪萨斯分枝杆菌肺病的病变累及下叶检出率低于耐药性肺结核,差异有统计学意义(P<0.05);两种疾病的影像特征大体相似,堪萨斯分枝杆菌肺病的肺容积减小、实变、下叶空洞、下叶支气管扩张、柱状支气管扩张检出率均低于耐药性肺结核,差异有统计学意义(P<0.05);两种疾病的其他影像特征比较,差异无统计学意义(P>0.05);与耐药性肺结核比较,堪萨斯分枝杆菌肺病的空洞壁具有薄、光滑、钙化少的特征,结节更小,差异有统计学意义(P<0.05)。治疗后复查CT时,堪萨斯分枝杆菌肺病确诊后首诊CT与复查CT的间隔时间短于耐药性肺结核,差异有统计学意义(P<0.05);堪萨斯分枝杆菌肺病影像随访好转率高于耐药性肺结核,差异有统计学意义(P<0.05)。结论堪萨斯分枝杆菌肺病与耐药性肺结核的CT影像特征存在一定差异,分析两者的CT影像特征有助于疾病的鉴别诊断。Objective The CT imaging characteristics of Mycobacterium kansasii pulmonary disease and drug-resistant pulmonary tuberculosis were compared to improve the level of differential diagnosis.Methods The clinical and imaging data of 40 patients diagnosed with Mycobacterium kansasii pulmonary disease and 40 patients diagnosed with drug-resistant pulmonary tuberculosis from January 2015 to October 2019 in Tianjin Haihe Hospital was retrospectively analyzed.Their CT imaging data was compared.Results When first diagnosed by CT,the imaging characteristics of the two diseases showed that the lesions of two lungs were widely distributed,and the detection rate of lesions involving the lower lobe in Mycobacterium kansasii pulmonary disease was lower than that in drug-resistant pulmonary tuberculosis,and the difference was statistically significant(P<0.05).The imaging characteristics of the two diseases are similar.Lung volume decreased,consolidation,cavity in lower lobes,bronchiectasis in lower lobes and columnar bronchiectasis were observed less frequently in Mycobacterium kansasii pulmonary disease than in drug-resistant pulmonary tuberculosis,and the differences were statistically significant(P<0.05).There was no significant difference in other imaging features between the two diseases(P>0.05).Compared with drug-resistant pulmonary tuberculosis,Mycobacterium kansasii pulmonary disease had thinner,smoother,less calcification wall and smaller nodules,and the differences were statistically significant(P<0.05).When CT was reexamined after treatment,the interval between the first diagnosis of CT and the reexamination of CT after the diagnosis of Mycobacterium kansasii pulmonary disease was shorter than that of drug-resistant pulmonary tuberculosis,and the difference was statistically significant(P<0.05).The improvement rate of image for follow-up of Mycobacterium kansasii pulmonary disease was higher than that of drug-resistant pulmonary tuberculosis,and the difference was statistically significant(P<0.05).Conclusion The imagin

关 键 词：堪萨斯分枝杆菌 耐药性肺结核 CT 影像特征 鉴别诊断 

分 类 号：R521[医药卫生—内科学]