肺结核增殖结节CT表现特征及支气管结核影像重建诊断价值分析  

Analysis of CT Features of Proliferating Nodules of Pulmonary Tuberculosis and Diagnostic Value of Image Reconstruction for Bronchial Tuberculosis

作　　者：张方园 李本美 李发洲 ZHANG Fangyuan;LI Benmei;LI Fazhou(Jingzhou Chest Hospital Radiology,Jingzhou City,Hubei Province 434020)

机构地区：[1]湖北省荆州市胸科医院放射科,434020

出　　处：《医学理论与实践》2022年第16期2713-2716,共4页The Journal of Medical Theory and Practice

摘　　要：目的:探讨肺结核增殖结节CT表现特征及支气管结核影像重建诊断价值。方法:随机选取2021年1—5月于我院接受肺部螺旋CT检查并确诊肺结核合并支气管结核的患者共225例,筛选出现增殖结节的患者作为观察对象。所有出现增殖结节的患者进行支气管结核影像重建,分析支气管结核影像重建对增殖结节的定性诊断效果。结果:(1)增殖结节可见良性结节典型特征,结节边缘清晰,且CT平扫值、增强后动脉期以及静脉期扫描值更低,恶性结节患者可见结节有明显恶性病变,CT平扫值、增强后动脉期以及静脉期扫描值更高。(2)肺结核合并支气管结核患者增殖结节的螺旋CT灌注峰值时间明显高于恶性结节患者,增强峰值、血容量以及表面通透性明显低于恶性肿瘤患者,差异具有统计学意义(P<0.05)。(3)肺结核合并支气管结核患者CT三维重建表现可见有明显的病支气管不规则狭窄,管腔内凹凸不平,气管病变区域呈现跳跃性。增殖结节患者CT三维重建结果中存在分叶征、血管集束征的患者比例明显高于恶性结节患者,差异具有统计学意义(P<0.05)。(4)以增殖结节作为阳性诊断结果,根据肺结核合并支气管结核患者CT三维重建结果进行诊断:血管集束征阴性预测值、约登指数明显高于分叶征,差异具有统计学意义(P<0.05);其余诊断效能无明显差异,不具统计学意义(P>0.05)。结论:肺结核合并支气管结核患者的肺部增殖结节与恶性结节的CT表现存在差别;通过患者支气管结核的CT三维重建可提高患者肺部增殖结节的诊断准确率。Objective:To investigate the CT findings of pulmonary tuberculosis proliferating nodules and the diagnostic value of image reconstruction for bronchial tuberculosis.Methods:A total of 225 patients with pulmonary tuberculosis combined with bronchial tuberculosis were randomly selected from January 2021 to May 2021 in our hospital who underwent spiral CT examination of the lungs,and selected patients with proliferative nodules as the observation objects.All patients with proliferative nodules underwent image reconstruction of bronchial tuberculosis to analyze the qualitative diagnostic effect of image reconstruction of bronchial tuberculosis on proliferative nodules.Results:(1)Proliferative nodules can see the typical characteristics of benign nodules,the edges of the nodules are clear,and the CT plain scan value,enhanced arterial phase and balance phase scan values are lower.Patients with malignant nodules can see obvious malignant lesions in the nodules.CT plain scan value,enhanced arterial phase and equilibrium phase scan value are higher.(2)The spiral CT perfusion peak time of proliferating nodules in patients with pulmonary tuberculosis and bronchial tuberculosis was significantly longer than that of patients with malignant nodules,and the peak enhancement,blood volume,and surface permeability were significantly lower than those of patients with malignant tumors.The difference was statistically significant(P<0.05).(3)The CT three-dimensional reconstruction of patients with pulmonary tuberculosis and bronchial tuberculosis showed obvious irregular stenosis of the diseased bronchus,unevenness in the lumen,and skipping of the diseased area of the trachea.The proportion of patients with proliferative nodules with lobular sign and vascular clustering signs in the results of CT three-dimensional reconstruction was higher than that of patients with malignant nodules,and the difference was statistically significant(P<0.05).(4)With proliferative nodules as the positive diagnosis result,the diagnosis was made based on t

关 键 词：肺结核 支气管结核 增殖结节 CT三维重建 

分 类 号：R521[医药卫生—内科学] R445[医药卫生—临床医学]