胸部X线与CT扫描在肺结核诊断中的应用效果比较  

Comparison of the Effect of Chest X-Ray and CT Scan in the Diagnosis of Pulmonary Tuberculosis

作　　者：刘琳琳 LIU Linlin(Department of Laboratory,Zaozhuang Center for Disease Control and Prevention of Shizhong District,Zaozhuang 277000,China)

机构地区：[1]山东省枣庄市市中区疾控预防控制中心检验科,山东枣庄277000

出　　处：《中国伤残医学》2024年第21期109-111,120,共4页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的:对比胸部CT扫描与X线在肺结核诊断中的效果,并评估二者的准确率,以期为临床肺结核诊断提供更可靠的影像学诊断方法依据。方法:回顾性分析2021年1月—2024年8月于枣庄市市中区疾控预防中心就诊的350例疑似肺结核患者资料,所有患者均接受胸部X线与CT扫描,并以病原学检查作为诊断“金标准”,对胸部X线与CT扫描的诊断效能进行评估,并分析二者与病原学检查结果的一致性。结果:经病原学检查确认,350例疑似肺结核患者中,阳性病例225例,阴性病例125例。胸部X线检查阳性218例,阴性132例;胸部CT扫描阳性220例,阴性130例。胸部CT扫描的灵敏度为92.77%、特异度为92.09%、准确度为92.51%、阳性预测值为94.97%、阴性预测值为88.79%,均高于胸部X线扫描检查的87.57%、85.58%、86.81%、90.72%、81.06%,差异均有统计学意义(P<0.05)。与病原学检查结果比较,胸部X线检查结果的Kappa值为0.724,CT扫描的Kappa值为0.843,胸部CT扫描检查结果的一致性较高。结论:胸部CT扫描检查在肺结核诊断中的诊断效能高于胸部X线检查,且与病原学检查结果的诊断一致性更高。因此,胸部CT扫描在肺结核诊断中具有更高的应用价值。Objective:To compare the effects of chest CT and X-ray scan in the diagnosis of pulmonary tuberculosis,and to evaluate the accuracy of the both,in order to provide a more reliable basis for clinical diagnosis of pulmonary tuberculosis.Method:Data of 350 patients with suspected pulmonary tuberculosis admitted to the Zaozhuang Center for Disease Control and Prevention of Shizhong District from January 2021 to August 2024 were retrospectively analyzed.All patients received chest X-ray and CT scan,and etiological examination was used as the“gold standard”for diagnosis.The diagnostic efficacy of chest X-ray and CT scan was evaluated.The consistency between the both and the results of etiological examination was analyzed.Results:Among 350 suspected patients with pulmonary tuberculosis,225 were positive and 125 were negative.Chest X-ray examination was positive in 218 cases and negative in 132 cases.Chest CT scan was positive 220 cases and negative 130 cases.Sensitivity of chest CT scan was 92.77%,specificity was 92.09%,accuracy was 92.51%,positive predictive value was 94.97%,negative predictive value was 88.79%.They were higher than 87.57%,85.58%,86.81%,90.72%,81.06%in chest X-ray examination,the differences were statistically significant(P<0.05).Compared with the results of etiology,the Kappa value of chest X-ray examination was 0.724 and that of CT scan was 0.843,indicating a higher consistency of chest CT scan results.Conclusion:The diagnostic efficacy of chest CT scan in the diagnosis of pulmonary tuberculosis is higher than that of chest X-ray examination,and the diagnostic consistency with etiology is higher.Therefore,chest CT scan has higher application value in the diagnosis of tuberculosis.

关 键 词：肺结核 CT扫描 X线 诊断效能 病原学检查 

分 类 号：R521[医药卫生—内科学]