胸部CT血管造影在活动性肺结核合并肺栓塞中的应用价值  

Application value of chest CT angiography in active pulmonary tuberculosis complicated with pulmonary embolism

作　　者：唐亮[1,4] 侯志丽 仲玲珊[1,4] 李志玲 邢志珩 徐静[3,4] Tang Liang;Hou Zhili;Zhong Lingshan;Li Zhiling;Xing Zhiheng;Xu Jing(Department of Radiology,Tianjin Haihe Hospital,Tianjin 300350,China;Department of Tuberculosis,Tianjin Haihe Hospital,Tianjin 300350,China;Department of Ultrasound,Tianjin Haihe Hospital,Tianjin 300350,China;Tianjin Institute of Respiratory Diseases,TCM Key Research Laboratory for Infectious Disease Prevention for State Administration of Traditional Chinese Medicine,Tianjin 300350,China)

机构地区：[1]天津市海河医院放射科,300350 [2]天津市海河医院结核科,300350 [3]天津市海河医院超声科,300350 [4]天津市呼吸疾病研究所,国家中医药管理局中医药防治传染病重点研究室,300350

出　　处：《国际生物医学工程杂志》2021年第5期374-378,共5页International Journal of Biomedical Engineering

摘　　要：目的探讨活动性肺结核合并肺栓塞患者胸部CT血管造影的影像学特点,以提高活动性肺结核合并肺栓塞的检出率。方法回顾性分析2013年1月至2020年1月天津市海河医院收治的103例活动性肺结核患者的临床资料,包括一般情况、症状及合并症。根据是否发生肺栓塞分为活动性肺结核合并肺栓塞组(研究组,n=43)和活动性肺结核无肺栓塞组(对照组,n=60)。统计研究组肺栓塞发生时间距离活动性肺结核发病的时间;分析两组患者活动性肺结核的胸部CT影像学特点,并对研究组患者肺栓塞的影像学特征、栓塞分布情况及继发改变进行总结。结果研究组出现肺栓塞的时间距离结核病发病60(14~75)d;研究组患者胸闷、呼吸困难的发生率均明显高于对照组(均P<0.05);研究组患者肺内病变累及肺叶数目明显高于对照组(P<0.05);研究组右肺中叶、左肺舌叶及双肺下叶的病变发生率均高于对照组(均P<0.05);研究组周围型肺栓塞的发生率明显高于中央型肺栓塞(P<0.05),但中央型肺栓塞患者肺不张、肺动脉增宽、右心脏增大的发生率均明显高于周围型肺栓塞患者(均P<0.05)。结论多层螺旋CT胸部血管造影可显示活动性肺结核合并肺栓塞患者的一些重要影像学表现,及早发现有助于改善其预后。Objective To investigate the imaging characteristics of chest CT angiography in patients with active pulmonary tuberculosis complicated with pulmonary embolism,so as to improve the detection rate of active pulmonary tuberculosis complicated with pulmonary embolism.Methods The clinical data of 103 patients with active pulmonary tuberculosis treated in Tianjin Haihe Hospital from January 2013 to January 2020 were retrospectively analyzed,including general conditions,symptoms and complications.According to the occurrence of pulmonary embolism,the patients were divided into active pulmonary tuberculosis complicated with pulmonary embolism group(study group,n=43)and active pulmonary tuberculosis without pulmonary embolism group(control group,n=60).The time between the onset of pulmonary embolism and the onset of tuberculosis of the patients in the study group was collected.The chest CT imaging characteristics of the patients of two groups were analyzed.The imaging characteristics,embolism distribution and secondary changes of the patients in the study group were summarized.Results Time from onset of tuberculosis to pulmonary embolism of the patients in the study group was about 60 days(14 days to 75 days).The incidence of chest tightness and dyspnea of the patients in the study group was significantly higher than that in the control group(all P<0.05).The number of lung lobes involved in lung lesions of the patients in the study group was significantly higher than that in the control group(P<0.05).The incidence of lesions in the middle lobe of the right lung,the tongue lobe of the left lung and the lower lobes of both lungs of the patients in the study group was higher than that in the control group(all P<0.05).The incidence of peripheral pulmonary embolism was significantly higher than that of central pulmonary embolism(P<0.05).However,the incidence of atelectasis,pulmonary artery widening,and right heart enlargement in the patients with central pulmonary embolism was significantly higher than that in the patients wit

关 键 词：肺栓塞 活动性肺结核 多层螺旋CT 胸部CT血管造影 

分 类 号：R521[医药卫生—内科学] R563.5[医药卫生—临床医学]