摘要
目的探讨多层螺旋CT(MSCT)征象特征与肺结核活动性及临床症状体征的相关性。方法回顾性选取2020年1月至2021年12月在湖南省结核病防治所治疗的活动性肺结核患者65例(观察组),非活动性肺结核患者70例(对照组)。比较两组MSCT征象差异,用受试者工作特征(ROC)曲线分析活动性肺结核的诊断价值。同时分析观察组患者临床症状体征与MSCT征象的关系。结果观察组CT征象为树芽征、空洞、磨玻璃影、肺实变患者比率分别为66.15%、76.92%、63.08%和47.69%,明显高于对照组(24.29%、15.71%、17.14%、20.00%),而钙化灶、纤维条索影患者比率分别为16.92%和26.15%,明显低于对照组(44.29%、45.71%),差异均有统计学意义(P<0.05)。将MSCT征象树芽征、空洞、磨玻璃影、肺实变、钙化灶、纤维条索影作为自变量构建Logistic回归方程,其诊断活动性肺结核的ROC曲线下面积为0.871,灵敏性和特异性分别为84.60%和71.40%。观察组有咳嗽患者树芽征、空洞患者比率分别为77.78%和88.89%,明显高于无咳嗽患者(40.00%、50.00%),差异均有统计学意义(P<0.05)。观察组有咯血患者树芽征、空洞、磨玻璃影、支气管充气征患者比率分别为86.21%、89.66%、79.32%和86.21%,均明显高于无咯血患者(50.00%、66.67%、50.00%、30.56%),而纤维条索影患者比率为10.34%,明显低于无咯血患者(38.89%),差异均有统计学意义(P<0.05)。观察组有胸痛患者空洞、磨玻璃影患者比率分别为95.24%和85.71%,均明显高于无胸痛患者(68.18%、52.27%),差异均有统计学意义(P<0.05)。结论活动性肺结核和非活动性肺结核MSCT征象有所差异,同时MSCT征象与活动性肺结核患者咳嗽、咯血及胸痛症状有一定关系。
Objective To investigate the correlation of multislice spiral CT(MSCT)features with pulmonary tuberculosis activity,and clinical symptoms and signs.Methods A total of 65 patients with active pulmonary tuberculosis(observation group)and 70 patients with inactive pulmonary tuberculosis(control group)who were treated in Hunan Institute for Tuberculosis Control from January 2020 to December 2021 were retrospectively selected,the differences of MSCT signs between the two groups were compared.The diagnostic value of active pulmonary tuberculosis was analyzed using the receiver operating characteristic(ROC)curve.At the same time,the relationship between clinical symptoms and signs of patients in the observation group and MSCT signs was analyzed.Results The CT signs in the observation group:the proportions of tree bud sign,cavity,ground glass shadow and lung consolidation were 66.15%,76.92%,63.08%and 47.69%respectively,which were significantly higher than those in the control group(24.29%,15.71%,17.14%,20.00%),the proportions of calcified lesions and fibrous strip shadows were 16.92%and 26.15%,respectively,which were significantly lower than the control group(44.29%,45.71%),the differences were statistically significant(P<0.05).MSCT signs such as tree bud sign,cavity,ground glass shadow,lung consolidation,calcification,and fibrous strip shadow were used as independent variables to construct a Logistic regression equation,the area under the ROC curve was 0.871,and the sensitivity and specificity were 84.60%and 71.40%respectively.The proportions of tree bud sign and cavity in patients with cough of observation group were 77.78%and 88.89%,respectively,which were significantly higher than those in patients without cough(40.00%,50.00%),the differences were statistically significant(P<0.05).The proportions of tree bud sign,cavity,ground glass shadow and bronchial air inflation sign in patients with hemoptysis of observation group were 86.21%,89.66%,79.32%and 86.21%,respectively,which were significantly higher than those in patients without hemoptysis(50.00%,66.67%,50.00%,30.56%),the proportion of fibrous cord shadow was 10.34%,which was significantly lower than that without hemoptysis(38.89%),and the differences were statistically significant(P<0.05),the differences were statistically significant(P<0.05).The proportionsof cavity and ground glass shadow in patients with chest pain of observation group were 95.24%and 85.71%,respectively,which were significantly higher than those in patients without chest pain(68.18%,52.27%),the differences were statistically significant(P<0.05).Conclusion The MSCT signs of active pulmonary tuberculosis are different from those of inactive pulmonary tuberculosis,and MSCT signs are related to cough,hemoptysis and chest pain in patients with active pulmonary tuberculosis.
作者
欧国建
凌杰
黄和平
OU Guo-jian;LING Jie;HUANG He-ping(Department of Radiology,Hunan Institute for Tuberculosis Control,Hunan Chest Hospital,Changsha Hunan 410205,China)
出处
《临床和实验医学杂志》
2023年第12期1319-1323,共5页
Journal of Clinical and Experimental Medicine
基金
湖南省卫计委科研项目(编号:D202309016496)。
关键词
多层螺旋CT
活动性肺结核
临床症状
影像征象
Multi slice spiral CT
Active pulmonary tuberculosis
Clinical symptoms
Imaging signs
