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中国防痨杂志 ›› 2011, Vol. 33 ›› Issue (8): 505-508.

• 论著 • 上一篇    下一篇

多层螺旋CT对DR胸片显示孤立病灶菌阴肺结核的诊断价值

黎惠如 刘文   

  1. 广州市胸科医院放射科 广州 510095
  • 收稿日期:2011-04-07 出版日期:2011-08-10 发布日期:2012-01-29

Diagnostic value of multi-slice spiral CT(MSCT) for sputum smear- and culture- negative pulmonary tuberculosis with solitary node in chest DR X-ray

Li Huiru, Liu Wen   

  1. Department of Radiology,Guangzhou Chest Hospital, Guangzhou  510095, China
  • Received:2011-04-07 Online:2011-08-10 Published:2012-01-29

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摘要： 摘要：目的  探讨多层螺旋CT（MSCT）对数字成像（digital radiography,DR）胸片显示孤立病灶菌阴肺结核的诊断价值。方法   回顾性对照分析180例经过临床确诊的DR胸片显示孤立病灶菌阴肺结核的MSCT表现，将不同MSCT层厚检测结果与DR胸片进行对比。结果   DR胸片发现空洞6例；5 mm 层厚MSCT重建显示15例，1 mm 层厚MSCT重建显示16例（DR胸片/5 mm 层厚MSCT  χ2＝4.096，P=0.043；DR胸片/1mm 层厚MSCT  χ2＝4.841，P=0.028）。5 mm层厚MSCT重建显示周围散在卫星灶50例，1 mm 层厚MSCT重建显示周围散在卫星灶55例，DR胸片没有显示，（DR胸片/5 mm 层厚MSCT  χ2＝65.616，P=0.001；DR胸片/1 mm 层厚MSCT  χ2＝68.882，P=0.001）。5 mm 层厚MSCT重建及1 mm 层厚MSCT重建显示阴影内钙化分别为120例和140例，明显多于DR胸片的20例，（DR胸片/5 mm 层厚MSCT  χ2＝116.883，P=0.001；DR胸片/1 mm 层厚MSCT  χ2＝162.000，P=0.001；5 mm 层厚MSCT/1 mm 层厚MSCT  χ2＝5.538，P=0.019）。5 mm 层厚MSCT重建及1 mm 层厚MSCT重建显示肿大淋巴结30例，DR胸片没有显示肿大淋巴结，（DR胸片/5 mm 层厚MSCT  χ2＝33.750，P=0.001；DR胸片/1 mm 层厚MSCT  χ2＝33.750，P=0.001）。DR胸片没有显示树芽征，1 mm MSCT显示10例(χ2＝9.907，P=0.007);DR胸片没显示磨砂玻璃影，1 mm MSCT显示15例(χ2＝15.882，P=0.001)。结论  多层螺旋CT对DR胸片显示孤立病灶的菌阴肺结核的诊断价值优于DR胸片。

关键词: 结核, 肺/放射摄影术, 体层摄影术, 螺旋计算机

Abstract: Abstract：Objective  To evaluate the diagnostic value of multi-slice spiral CT(MSCT) for sputum smear- and culture-negative pulmonary tuberculosis with solitary node shown in chest digital radiography(DR) X-ray. Methods   Solitary node shown in chest DR X-ray and MSCT among 180 cases with smear- and culture-negative pulmonary tuberculosis were analyzed retrospectively and solitary node shown in different section thickness of MSCT and chest DR X-ray were compared. Results   Chest DR X-ray showed cavities in 6 cases and 5 mm section thickness MSCT showed in 15 cases (χ2＝4.096，P=0.043) and 1 mm section thickness MSCT in 16 cases (χ2＝4.841，P=0.028). Satellites were seen in 50 cases with 5 mm section thickness MSCT(χ2＝65.616，P=0.001) and in 55 cases with  1 mm section thickness MSCT(χ2＝68.882，P=0.001), but no satellite was observed in chest DR X-ray. Calcification  was found in shadow among 120 cases with 5  mm section thickness multiplanar reconstruction MSCT(χ2＝116.883，P=0.001) and among 140 cases with 1mm section thickness multiplanar reconstruction MSCT(χ2＝162.000，P=0.001). However, there were only 20 cases found calcification in shadow with chest DR X-ray. There were also statistical differences in calcification of shadow between  5 mm and 1 mm section thickness multiplanar reconstruction MSCT(χ2＝5.538，P=0.019).  Enlarged lymph nodes were observed in 30 cases with  5 mm (χ2＝33.750，P=0.001)or 1 mm(χ2＝33.750，P=0.001) section thickness multiplanar reconstruction MSCT. There was no enlarged lymph node observed in Chest DR X-ray. Tree-in-bud sign was not shown with Chest DR X-ray in all patients and was shown with 1 mm MSCT among 10 patients (χ2＝9.907，P=0.007). Ground-glass opacities was not shown with chest DR X-ray in all patients and was shown with 1 mm MSCT among 10 patients(χ2＝15.882，P=0.001). Conclusion   MSCT is better in diagnosis of smear- and culture-negative pulmonary tuberculosis with solitary nodes than chest DR  X-ray. 

Key words: Tuberculosis,pulmonary/radiography, Tomography,spiral computed

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