肺结核与肺结核合并慢阻肺患者CT诊断情况及影像学特征比较  

CT Diagnosis And Imaging Features between Pulmonary Tuberculosis And COPD with Pulmonary Tuberculosis

作　　者：刘思宏 吕品 吴平 LIU Si-hong;LV Pin;WU Ping(Department of Imaging,Haian Hospital Affiliated to Nantong University,Haian 226600,Jiangsu Province,China)

机构地区：[1]南通大学附属海安医院影像科,江苏海安226600

出　　处：《中国CT和MRI杂志》2022年第9期60-62,共3页Chinese Journal of CT and MRI

摘　　要：目的 分析及比较肺结核与肺结核合并慢阻肺患者CT诊断情况及影像学特征。方法 经医院伦理学会批准随机选取医院2015年1月至2020年4月肺结核患者89例,其中单纯肺结核45例,将其纳入单纯组;另44例患者合并慢阻肺,将其纳入合并组。比较两组患者病灶分布、CT肺部E/L指标、影像学特征及临床表现。结果 单纯组患者病灶位于左肺上叶最常见,其次是右肺上叶尖后段,下叶背段最少。合并组患者病灶位于右肺上叶尖后段最常见,其次是左肺上叶,下叶背段最少。单纯组左肺上叶率高于合并组(P<0.05),下叶背段率低于合并组(P<0.05),右肺上叶尖率高于合并组(P>0.05),差异比较无统计学意义。合并组患者左肺、右肺、全肺E/L值高于单纯组(P<0.05)。单纯组患者肿块、“分叶”征、毛刺状结节、胸膜凹陷、空洞比低于合并组(P<0.05),条缩影比低于合并组(P>0.05),差异比较无统计学意义。两组患者的咳嗽、痰中带血、胸闷、气短、消瘦、低热比高于合并组(P>0.05),淋巴结肿大比低于合并组(P>0.05),差异比较无统计学意义。结论 肺结核合并慢阻肺患者CT征象以肿块、“分叶”征、“毛刺”征、胸膜凹陷、空洞为主,肺气肿容积较高,建立临床综合分析,从而提升肺结核与合并慢阻肺鉴别准确率。Objective To investigate the CT diagnosis and imaging features between pulmonary tuberculosis and COPD with pulmonary tuberculosis.Methods With the approval of the hospital ethics society,89 patients with tuberculosis in the hospital from January 2015 to April 2020 were randomly selected,including 45 patients with simple tuberculosis(simple group) and 44 patients with COPD and pulmona ry tuberculosis(combined group).The lesion distribution,CT lung E/L index,imaging featu res and clinical manifestations of the two groups were compared.Results In the simple group,lesions were most common in the left upper lobe,followed by the posterior lobe tip of the right upper lobe,and the dorsal lobe of the lower lobe.In the combined group,the lesions were most common in the posterior segment of the right upper lobe tip,followed by the left upper lobe and the dorsal segment of the lower lobe.The proportion of lesions located in left upper lobe was higher than that of combined group(P<0.05),the proportion of dorsal lobe of lower lobe was lower than that of combined group(P<0.05),and the proportion of the upper lobe tip of the right lung was higher than that of combined group(P>0.05).E/L values of left lung,right lu ng and whole lung in combined group were higher than those in simple group(P<0.05).The ratio of mass,lobula r sign,burr sign,pleu ral depression and cavity in simple group was lower than that in combined group(P<0.05),and the ratio of strip condensation was lower than that in combined group(P>0.05).The ratio of cough,blood in sputum,chest tightness,shortness of breath,emasmus and low fever in simple group was higher than that in combined group(P>0.05),and the ratio of lymph node enlargement was lower than that in combined group(P>0.05).Conclusion The CT signs of pulmonary tuberculosis patients with COPD are mainly mass,lobular sign,burr sign,pleural depression and cavity,and the emphysema volume was relatively high.Thus,the clinical comprehensive analysis may improve the identification accuracy between pulmonary tuber

关 键 词：肺结核 慢阻肺 CT 影像学 特征 分叶征 毛刺征 气肿 容积 

分 类 号：R445.3[医药卫生—影像医学与核医学] R521[医药卫生—诊断学]