探讨MSCT平扫在活动性肺结核临床治疗前、后中的应用价值
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摘要
目的探讨多层螺旋CT(MSCT)平扫在活动性肺结核临床治疗前、后中的应用价值。方法选取2016年12月至2018年8月我院连续收集的118例活动性肺结核患者作为研究对象,所有患者均予以抗结核治疗,治疗前后均行MSCT检查,整理分析118例活动性肺结核患者的临床及影像学资料,比较所有患者治疗前后期MSCT检查图像表现结果。结果 118例活动性肺结核患者治疗前MSCT检查活动性肺部征象检出率为100.00%(118/118),抗结核治疗后MSCT对其活动性肺部征象检出率为38.98%(46/118),比较差异间具有统计学意义(χ~2=121.026,P<0.001);整理相关影像学资料可知,经抗结核治疗后,MSCT检查示活动性肺结核患者其CT征象中毛玻璃样影、树芽征、支气管增厚以及节段分布小叶中心节吸收率均可达80.00%以上,斑块和球形病灶可见部分吸收,表明肺结核活动性的不确定,而支气管扩张和纤维索条及线影治疗前后MSCT检查中其征象表现未见明显变化,即提示该征象为活动性肺结核抗结核治疗后结核残留的主要征象。结论 MSCT可明确显示出活动性肺结核的病变征象和有利于观察治疗前后其肺部病变征象的演变和转化情况,更有助于评估活动性肺结核患者的治疗效果,为其治疗提供进一步的指导依据。
Objective To explore the application value of multi-slice spiral CT(MSCT) plain scan before and after clinical treatment of active tuberculosis. Methods 118 patients with active tuberculosis collected from our hospital from December 2016 to August 2018 were selected as subjects. All patients were treated with antituberculosis therapy. MSCT was performed before and after treatment. The clinical and imaging data of 118 patients with active tuberculosis were analyzed and compared. The results of MSCT images before and after treatment were compared. Results The detection rate of active pulmonary signs in 106 patients with active tuberculosis before treatment was 100.00%(118/118), and the detection rate of active pulmonary signs in MSCT after antituberculosis therapy was 38.98%(46/118),and the difference was statistically significant(χ~2=121.026, P<0.001).According to the relevant imaging data, after antituberculosis therapyt, the MSCT examination showed that in the CT signs of the patients with active tuberculosis,the absorption rate of shadow like frosted glass, tree-in-bud, bronchial thickening and segmental distribution of leaflet central nodes can reach more than 80.00%, and plaque and spherical lesions were partially absorbed,which indicated the uncertainty of the activity of tuberculosis. However, there was no significant change in the signs of bronchiectasis and fibrous stripes and hachure in MSCT examination before and after treatment, which suggested that this sign was the main sign of residual tuberculosis after antituberculosis therapy. Conclusion MSCT can clearly show the signs of active tuberculosis and it is useful to observe the evolution and transformation of signs lung before and after treatment. It is more helpful to evaluate the therapeutic effect of patients with active tuberculosis and provide further guidance for their treatment.
Objective To explore the application value of multi-slice spiral CT(MSCT) plain scan before and after clinical treatment of active tuberculosis. Methods 118 patients with active tuberculosis collected from our hospital from December 2016 to August 2018 were selected as subjects. All patients were treated with antituberculosis therapy. MSCT was performed before and after treatment. The clinical and imaging data of 118 patients with active tuberculosis were analyzed and compared. The results of MSCT images before and after treatment were compared. Results The detection rate of active pulmonary signs in 106 patients with active tuberculosis before treatment was 100.00%(118/118), and the detection rate of active pulmonary signs in MSCT after antituberculosis therapy was 38.98%(46/118),and the difference was statistically significant(χ~2=121.026, P<0.001).According to the relevant imaging data, after antituberculosis therapyt, the MSCT examination showed that in the CT signs of the patients with active tuberculosis,the absorption rate of shadow like frosted glass, tree-in-bud, bronchial thickening and segmental distribution of leaflet central nodes can reach more than 80.00%, and plaque and spherical lesions were partially absorbed,which indicated the uncertainty of the activity of tuberculosis. However, there was no significant change in the signs of bronchiectasis and fibrous stripes and hachure in MSCT examination before and after treatment, which suggested that this sign was the main sign of residual tuberculosis after antituberculosis therapy. Conclusion MSCT can clearly show the signs of active tuberculosis and it is useful to observe the evolution and transformation of signs lung before and after treatment. It is more helpful to evaluate the therapeutic effect of patients with active tuberculosis and provide further guidance for their treatment.
引文
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[6]张强军,张晓明.活动性及非活动性肺结核CT征象对不同类型肺结核的鉴别诊断价值[J].中国CT和MRI杂志,2017,14(1):306-308.
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[8]刘扬,龚圣兵,陈严,等.中年人初发活动性肺结核的CT影像特点[J].临床肺科杂志,2017,21(7):209-211.
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[11]张洁,于洪志,吴琦,等.活动性肺结核淋巴管周围受累的CT影像和临床特征分析[J].中华医学杂志,2016,96(3):167.
[12]杜娟琳.多层螺旋C T在肺结核诊断和鉴别诊断中的应用价值[J].解放军预防医学杂志,2016,33(1):203-204.
[13]姚景江,贺亚琼,张亚林.非结核分枝杆菌肺病的临床与M S C T表现[J].中国医学影像技术,2017,32(3):99-103.
[14]钟剑峰,童涌,宋群,等.IGRA与TST在肺结核痰菌阳性患者家庭密切接触者感染的诊断评价[J].中华医院感染学杂志,2018,28(11):37-40.
[15]王守玉,周世富,吉强.多层螺旋CT在不典型肺结核诊断中的应用价值探讨[J].中国CT和MRI杂志,2018,15(12):86-88.
[2]张强军,张晓明.活动性及非活动性肺结核CT征象对不同类型肺结核的鉴别诊断价值[J].中国CT和MRI杂志,2017,14(1):267-269.
[3]杨保智,侯浩宇,任倩.64排螺旋CT对活动性肺结核的评价[J].生物医学工程与临床,2016,19(6):605-608.
[4]王乔.高职院校肺结核疫情的预防和应对机制[J].保健医学研究与实践,2018,15(2):84-87.
[5]刘新忠.CT诊断涂阴肺结核及疗效评估[J].中国医学影像技术,2016,32(4):526-529.
[6]张强军,张晓明.活动性及非活动性肺结核CT征象对不同类型肺结核的鉴别诊断价值[J].中国CT和MRI杂志,2017,14(1):306-308.
[7]王晓燕,孙光红.2011-2017年广元市学生肺结核流行特征分析[J].预防医学情报杂志,2018,33(10):109-111.
[8]刘扬,龚圣兵,陈严,等.中年人初发活动性肺结核的CT影像特点[J].临床肺科杂志,2017,21(7):209-211.
[9]吴志明,陈国裕,胡晔.涂阳肺结核患者密切接触者筛查情况分析[J].中国实用医药,2013,16(25):383-384.
[10]Fukushi M,Tan E M,Nobuyuki N,et al.Increased Case Notification through Active Case Finding of Tuberculosis among Household and Neighbourhood Contacts in Cambodia[J].PLOS ONE,2016,11(3):e0150405.
[11]张洁,于洪志,吴琦,等.活动性肺结核淋巴管周围受累的CT影像和临床特征分析[J].中华医学杂志,2016,96(3):167.
[12]杜娟琳.多层螺旋C T在肺结核诊断和鉴别诊断中的应用价值[J].解放军预防医学杂志,2016,33(1):203-204.
[13]姚景江,贺亚琼,张亚林.非结核分枝杆菌肺病的临床与M S C T表现[J].中国医学影像技术,2017,32(3):99-103.
[14]钟剑峰,童涌,宋群,等.IGRA与TST在肺结核痰菌阳性患者家庭密切接触者感染的诊断评价[J].中华医院感染学杂志,2018,28(11):37-40.
[15]王守玉,周世富,吉强.多层螺旋CT在不典型肺结核诊断中的应用价值探讨[J].中国CT和MRI杂志,2018,15(12):86-88.
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