非结核分枝杆菌肺病与肺结核患者的CT影像特征分析  

The Analysis of CT Imaging Features in Patients with Non-Tuberculous Mycobacteria Lung Disease and Pulmonary Tuberculosis

作　　者：仲玲珊 王莉[1] 张硕[1] 邢志珩 Zhong Lingshan;Wang Li;Zhang Shuo;Xing Zhiheng(Haihe Hospital,Tianjin University,Tianjin Haihe Hospital,Tianjin Institute of Respiratory Diseases,TCM Key Research Laboratory for Infectious Disease Prevention for National Administration of Traditional Chinese Medicine,Tianjin 300350,China)

机构地区：[1]天津大学海河医院·天津市海河医院·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,天津300350

出　　处：《医疗装备》2024年第14期1-4,共4页Medical Equipment

基　　金：天津市科技计划项目(21JCYBJC00510);天津市医学重点学科(专科)建设项目资助(TJYXZDXK-067C);天津市医学重点学科(专科)建设项目资助(TJYXZDXK-063B);天津市海河医院科技资金(HHYY-202007)。

摘　　要：目的分析比较非结核分枝杆菌肺病(NTM-LD)与肺结核(PTB)患者的CT影像特征及差异。方法回顾性分析2017—2023年医院收治的NTM-LD及PTB患者资料,将92例NTM-LD患者纳入NTM-LD组,92例PTB患者纳入PTB组。搜集两组的临床资料和胸部CT影像资料,分析比较两组CT征象的出现频次、空洞的洞壁厚度、内径,记录空洞和支气管扩张累及的肺叶。结果NTM-LD组年龄大于PTB组,喘息发生率高于PTB组(P<0.05);胸部CT影像中,NTM-LD组支气管扩张、淋巴结肿大、淋巴结钙化占比高于PTB组(P<0.05),结节占比低于PTB组(P<0.05);NTM-LD组空洞洞壁厚度小于PTB组(P<0.05);两组空洞内径比较,差异无统计意义(P>0.05);NTM-LD组右肺上叶、中叶、左肺上叶、舌叶支气管扩张发生率均高于PTB组(P<0.05)。结论NTM-LD与PTB患者的临床表现及CT影像有较多相似之处,CT影像中双肺广泛支气管扩张、多发薄壁空洞提示NTM-LD的可能性更大。Objective To analyze and compare the CT imaging features and differences between patients with non-tuberculous mycobacteria lung disease(NTM-LD)and pulmonary tuberculosis(PTB).Methods With the retrospective analysis of the data of NTM-LD and PTB patients admitted to the hospital from 2017 to 2023,92 NTM-LD patients were included in the NTM-LD group,and 92 PTB patients were included in the PTB group.With clinical data and chest CT imaging data of two groups collected,the frequency of CT signs,cavity wall thickness and inner diameter,and the pulmonary lobes involved in cavity and bronchiectasis were analyzed and compared between the two groups.Results The age of NTM-LD group was higher than that of PTB group,and the incidence of wheezing was higher than that of PTB group(P<0.05);In the chest CT findings,the proportion of bronchiectasis,lymph node enlargement,and lymph node calcification in the NTM-LD group was higher than in the PTB group(P<0.05),and the proportion of nodules in the NTM-LD group was lower than in the PTB group(P<0.05);The thickness of the cavity wall in the NTM-LD group was smaller than that in the PTB group(P<0.05);There was no statistically significant difference in the inner diameter of the two groups of cavities(P>0.05);The incidence of bronchiectasis in the right upper lobe,middle lobe,left upper lobe,and tongue lobe of the NTM-LD group was higher than that of the PTB group(P<0.05).Conclusions There are many similarities in clinical manifestations and CT images between nontuberculous mycobacteria lung disease and pulmonary tuberculosis patients.The appearance of extensive bronchiectasis and multiple thin-walled cavities in both lungs on CT images suggests a higher possibility of non-tuberculous mycobacteria lung disease.

关 键 词：非结核分枝杆菌 结核分枝杆菌 CT影像 

分 类 号：R445.3[医药卫生—影像医学与核医学]