以肺间质病变为主的不典型肺结核CT征象分析和疗效判断  

Analysis of CT Signs and Efficacy Evaluation of Atypical Pulmonary Tuberculosis with Interstitial Lesions as the Main Focus

作　　者：庄剑伟 曾乐飞 罗颖梅 范育超 ZHUANG Jian-wei;ZENG Le-fei;LUO Ying-mei;FAN Yu-chao(Department of Radiology,Huangpu District Traditional Chinese Medicine Hospital,Guangdong510700,China)

机构地区：[1]广州市黄埔区中医医院放射科,广东510700

出　　处：《影像技术》2023年第5期51-55,60,共6页Image Technology

摘　　要：目的:探讨以肺间质病变为主的不典型肺结核CT征象分析和疗效判断。方法:回顾性分析2020年1月至2022年9月在我院结核门诊就诊的43例以肺间质病变为主的不典型肺结核患者CT影像学表现,所有患者均接受CT检查及肺结核治疗,比较治疗前后不同时间段病变区域的CT征象,并分析抗结核的治疗效果。结果:治疗前43例患者CT扫描表现显示:检出细网织状影43例,检出率为100.00%;检出微结节43例,检出率为100.00%;检出树芽征32例,检出率为74.42%;检出小叶间隔加厚25例,检出率为58.14%;检出磨玻璃样影28例,检出率为65.12%;检出支气管壁增厚22例,检出率为51.16%。不规则细网织状影CT下主要表现为小叶间隔增厚且不均匀,边界模糊,伴有支气管血管束异常。节段性改变呈大小不均匀的较规则磨玻璃样密度细网织状影,CT下主要表现为小叶间隔增厚且均匀,边界清晰,病变组织周围伴有细线状阴影,约5-30mm,肺小叶模糊。治疗3个月后,细网织装影、微结节检出率相较于治疗前下降,差异均有统计学意义(P<0.05),其他征象检出率相较于治疗前差异均无统计学意义(P>0.05)。治疗6个月后、治疗9个月后所有CT扫描主要征象检出率相较于治疗前均下降,差异均有统计学意义(P<0.05)。结论:CT征象对于以肺间质病变为主的不典型肺结核患者诊断价值较高,可准确、清晰观察到以肺间质病变为主的不典型肺结核患者影像学表现,并有助于后续患者疗效判断,值得临床推广。Objective:To explore the CT imaging analysis and its judgement on therapeutic effect of atypical pulmonary tuberculosis,mainly pulmonary interstitial lesions.Methods:A retrospective analysis was conducted on the CT imaging manifestations of 43 atypical pulmonary tuberculosis patients with pulmonary interstitial lesions who visited our hospital's tuberculosis clinic from January 2020 to September2022.All patients underwent CT examination and tuberculosis treatment,and the CT signs of the diseased areas at different time periods before and after treatment were compared,and the effectiveness of anti-tuberculosis treatment was analyzed.Results:Before treatment,CT scans of 43 patients showed that43 cases had fine mesh like shadows,with a detection rate of 100.00%;43 cases of micro nodules were detected,with a detection rate of 100.00%;32 cases of tree bud sign were detected,with a detection rate of 74.42%;25 cases of interlobular septal thickening were detected,with a detection rate of 58.14%;28cases of ground glass opacity were detected,with a detection rate of 65.12%;22 cases of bronchial wall thickening were detected,with a detection rate of 51.16%.The main manifestation of irregular fine mesh shadow on CT is thickening and uneven interlobular septa,blurry boundaries,and accompanied by abnormal bronchovascular bundles.The segmental changes present as irregular ground glass like dense fine mesh like shadows with uneven size,the main manifestation of it on CT is thickening and uniformity of interlobular septa,clear boundaries,and thin line shadows around the lesion tissue,approximately 5-30mm,with blurred pulmonary lobules.After 3 months of treatment,the detection rates of fine mesh woven shadows and micro nodules decreased compared to before treatment,and the differences were statistically significant(P<0.05).The detection rates of other signs showed no statistically significant difference compared to before treatment(P>0.05).After 6 months of treatment and 9 months of treatment,the detection rate of all major signs

关 键 词：肺间质病变 肺结核 CT征象 疗效判断 

分 类 号：R521.9[医药卫生—内科学]