关键词: 结核,肺, 抗药物性, 体层摄影术,X线计算机, 诊断显像, 疾病特征

Abstract:

Objective To explore the CT features of drug-resistant tuberculosis (DR-TB) patients with cavity,in order to improve diagnosis for DR-TB with cavity. Methods A retrospective analysis of 56 cases of pulmonary DR-TB with cavity (group A) confirmed by drug susceptibility test(proportional method) in Guangzhou Chest Hospital from January 2018 to December 2019.At the same time, 56 cases of drug-sensitive pulmonary tuberculosis with cavity (group B) were collected for comparative analysis, matching each Group A patient with the same gender and age ±2 years. By comparing CT scanning findings of the two groups,we analyzed the CT features of DR-TB with cavity. Results In group A, the detection rates of number of cavities ≥3, cavities located in ≥3 lung lobes were 55.36% (31/56) and 46.43% (26/56) respectively. In group B, they were 32.14% (18/56) and 26.79% (15/56) respectively.The differences between the two groups were statistically significant (χ ²=6.132 and 4.655,P=0.013 and 0.031, respectively). In group A, the detection rates of thick wall cavity and destroyed lungs were 61.44% (94/153) and 32.14% (18/56) respectively,while in group B, they were 49.21% (62/126) and 14.29% (8/56) respectively. The differences between the two groups were statistically significant (χ²=4.194 and 5.009, P=0.041 and 0.025, respectively). The detection rates of thin-walled cavity, drainage bronchus and tree bud sign in group B were 30.16% (38/126), 40.48% (51/126), 51.79% (29/56) respectively.In group A,they were 14.38% (22/153), 28.10% (43/153), 32.14% (18/56) respectively. There were significant differences between the two groups (χ ²=10.192, 4.734, 4.436, P=0.001, 0.030, 0.035, respectively). Conclusion The CT scan of DR-TB with cavity is more likely to have number of cavities ≥3, cavities located in ≥3 lung lobes, thick wall cavity and destroyed lung. The CT scan of drug-sensitive pulmonary tuberculosis with cavity is more likely to show thin-walled cavity, drainage bronchus and tree bud sign.They have their own CT features which can provide help for early clinical diagnosis and treatment。

Key words: Pulmonary tuberculosis, Drug resistance, Tomography, X-ray and computer, Diagnostic imaging, Disease characteristics