多层螺旋CT在肺结核鉴别及其活动性判断中的应用价值  

Application Value of Multi-slice Spiral CT in Differential Diagnosis and Activity Judgment of Pulmonary Tuberculosis

作　　者：王文秀[1] 纪俊雨[1] 郝蒙[1] 刘树芳[1] WANG Wen-xiu;JI Jun-yu;HAO Meng;LIU Shu-fang(Department of Radiology,Hebei Chest Hospital,Shijiazhuang 050041,Hebei Province,China)

机构地区：[1]河北省胸科医院放射科,河北石家庄050041

出　　处：《中国CT和MRI杂志》2025年第4期87-89,共3页Chinese Journal of CT and MRI

摘　　要：目的探讨多层螺旋CT(MSCT)在肺结核鉴别及其活动性判断中的应用价值。方法选取2019年12月至2020年12月期间医院98例疑似肺结核的患者作为研究对象,全部患者入院时均接受MSCT检查和痰结核分枝杆菌培养,以痰结核分枝杆菌培养的诊断结果作为“金标准”,分析MSCT对肺结核、活动性肺结核的诊断结果与痰结核分枝杆菌培养诊断结果的一致性,评估MSCT检查分别对肺结核、活动性肺结核的诊断效能及应用价值。结果全部98例疑似肺结核患者中,经痰结核分枝杆菌培养检查,结果显示,阳性93例,占比为94.90%(93/98),阴性5例,占比为5.10%(5/98);活动性肺结核56例,占比为60.22%(56/93),非活动性肺结核37例,占比为39.78%(37/93);本次对98例疑似肺结核患者的研究发现,MSCT检查肺结核的准确率为91.84%(90/98),敏感度为93.55%(87/93),特异度为60.00%(3/5),阳性预测值97.75%(87/89),阴性预测值33.33%(3/9)。MSCT检查活动性肺结核的准确率为96.77%(90/93),敏感度为100.00%(56/56),特异度为97.29%(36/37),阳性预测值98.18%(54/55),阴性预测值94.74%(36/38)。结论使用MSCT检查能够准确的诊断患者是否患有肺结核、活动性肺结核,临床可推广使用。Objective To explore the application value of multi-slice spiral CT(MSCT)in differentiating pulmonary tuberculosis and judging its activity.Methods From December 2019 to December 2020,98 patients with suspected pulmonary tuberculosis were selected as the research object.All patients received MSCT examination and culture of Mycobacterium tuberculosis in sputum when they were admitted to the hospital.Taking the diagnosis result of culture of Mycobacterium tuberculosis in sputum as the"gold standard",the consistency between the diagnosis results of pulmonary tuberculosis and active pulmonary tuberculosis by MSCT and the diagnosis results of culture of Mycobacterium tuberculosis in sputum was analyzed,and the diagnostic efficiency and application value of MSCT examination for pulmonary tuberculosis and active pulmonary tuberculosis were evaluated.Results Among all 98 suspected pulmonary tuberculosis patients,93 cases were positive(94.90%)and 5 cases were negative(5.10%)by sputum culture examination.There were 56 cases of active pulmonary tuberculosis,accounting for 60.22%(56/93),and 37 cases of inactive pulmonary tuberculosis,accounting for 39.78%(37/93).This study of 98 suspected pulmonary tuberculosis patients found that the accuracy,sensitivity,specificity,positive predictive value and negative predictive value of MSCT were 91.84%(90/98),93.55%(87/93),60.00%(3/5),97.75%(87/89)and 33.33%respectively.The accuracy,sensitivity,specificity,positive predictive value and negative predictive value of MSCT in detecting active pulmonary tuberculosis were 96.77%(90/93),100.00%(56/56),97.29%(36/37),98.18%(54/55)and 94.74%(36/38)respectively.Conclusion MSCT can accurately diagnose whether patients have pulmonary tuberculosis or active pulmonary tuberculosis,and can be widely used in clinic.

关 键 词：肺结核 活动性 多层螺旋CT 诊断 

分 类 号：R521[医药卫生—内科学]