64排螺旋CT在继发性肺结核合并真菌感染及肺结构异常诊断中的应用价值  

Application value of 64-slice spiral CT in diagnosis of secondary pulmonary tuberculosis complicated with fungal infection and abnormal lung structure

作　　者：李志龙 Li Zhilong(Department of Radiology,Zhangye Traditional Chinese Medicine Hospital,Gansu734000,China)

机构地区：[1]甘肃省张掖市中医医院放射科,734000

出　　处：《实用医学影像杂志》2023年第6期425-429,共5页Journal of Practical Medical Imaging

摘　　要：目的 研究64排螺旋CT在继发性肺结核合并真菌感染及肺结构异常诊断中的应用价值。方法 选取2020年11月至2022年11月张掖市中医医院收治的疑似继发性肺结核合并真菌感染患者90例,均进行肺部64排螺旋CT和彩色多普勒超声检查,同时选取患者痰液进行真菌培养分析,并以最终真菌培养检查结果作为继发性肺结核合并真菌感染的诊断金标准,探究64排螺旋CT诊断价值。结果 经真菌培养检查发现,患者痰液中均出现结核分歧杆菌,确诊为继发性肺结核,并发真菌感染,检出真菌以曲霉菌(68.0%)和白色念珠菌(32.0%)为主,同时64排螺旋CT关于继发性肺结核合并真菌感染诊断误诊率为11.1%,低于彩色多普勒超声检查误诊率26.7%,且多排螺旋CT诊断灵敏度、准确度和特异度,以及肺结构异常相关病症有效诊断率分别为88.0%,88.9%,90.0%,45.6%,分别高于彩色多普勒超声检查的70.0%,73.3%,77.5%,21.1%(P<0.05)。结论 在继发性肺结核合并真菌感染及肺结构异常的早期诊断中,多排螺旋CT检查,能够进一步明确患者病症的病变程度和病变趋势,同时结合真菌培养分析,检出感染性真菌种类,便于为后续开展针对性治疗,此外,关于肺结构异常相关病症的多排螺旋CT诊断也有助于为肺部病症的临床预防和早期干预提供诊断依据,显著证实其使用价值。Objective To study the application value of 64-slice spiral CT in the diagnosis of secondary pulmonary tuberculosis complicated with fungal infection and abnormal lung structure.Methods A total of 90 patients with suspected secondary pulmonary tuberculosis complicated with fungal infection admitted to Zhangye Traditional Chinese Medicine Hospital from November 2020 to November 2022 were selected.64-row spiral CT and color Doppler ultrasonography were performed on the lungs,and the sputum of the patients was selected for fungal culture analysis.The results of the final fungal culture examination were used as the gold standard for the diagnosis of secondary pulmonary tuberculosis complicated with fungal infection,and the diagnostic value of 64-slice spiral CT was explored.Results Mycobacterium tuberculosis was found in the sputum of the patients,which was confirmed as secondary pulmonary tuberculosis complicated by fungal infection.Aspergillus(68.0%)and Candida albicans(32.0%)were the main fungi detected.Meanwhile,the misdiagnosis rate of secondary pulmonary tuberculosis combined with fungal infection by 64-slice spiral CT was 11.1%.The diagnostic sensitivity,accuracy and specificity of multi-slice spiral CT were 88.0%,88.9%,90.0%and 45.6%,respectively,which were higher than those of color Doppler ultrasonography(70.0%,73.3%,77.5%and 21.1%)(P<0.05).Conclusion In the early diagnosis of secondary tuberculosis combined with fungal infection and lung structural abnormalities,multi-slice spiral CT,as an effective imaging application method,can further clarify the degree and trend of the disease of the patient.At the same time,combined with fungal culture analysis,infectious fungal species can be detected,which is convenient for subsequent targeted treatment.The diagnostic results of multi-slice spiral CT on the diseases related to lung structural abnormalities can also provide diagnostic basis for the clinical prevention and early intervention of lung diseases.

关 键 词：超声检查 多普勒 彩色 结核 肺 继发性 真菌感染 多排螺旋CT检查 肺结构异常 

分 类 号：R521[医药卫生—内科学] R446.5[医药卫生—临床医学]