Analysis of CT features of drug-resistant pulmonary tuberculosis with cavity

doi:10.3969/j.issn.1000-6621.2021.04.008

Abstract

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

LIANG Rui-yun, FANG Wei-jun, REN Hui-li, LI Hui-ru, ZHANG Hui, LI Cheng-cheng. Analysis of CT features of drug-resistant pulmonary tuberculosis with cavity[J]. Chinese Journal of Antituberculosis, 2021, 43(4): 341-345. doi: 10.3969/j.issn.1000-6621.2021.04.008

Figures/Tables 4

References 20

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组别	例数	空洞数量			空洞分布范围
组别	例数	1个	2个	≥3个	1叶	2叶	≥3叶
A组	56	8(14.29)	17(30.36)	31(55.36)	15(26.79)	15(26.79)	26(46.43)
B组	56	15(26.79)	23(41.07)	18(32.14)	22(39.29)	19(33.93)	15(26.79)
χ²值		2.681	1.400	6.132	1.978	0.676	4.655
P值		0.102	0.237	0.013	0.160	0.411	0.031

空洞CT表现	A组(153个)		B组(126个)		χ²值	P值
空洞CT表现	个数	检出率(%)	个数	检出率(%)	χ²值	P值
类型
厚壁(>3mm)	94	61.44	62	49.21	4.194	0.041
薄壁(≤3mm)	22	14.38	38	30.16	10.192	0.001
无壁	37	24.18	26	20.63	0.498	0.481
形态
不规则形	74	48.37	61	48.41	0.000	0.994
圆形、类圆形	79	51.63	65	51.59	0.000	0.994
内壁
光滑	87	56.86	74	58.73	0.099	0.753
不光滑	42	27.45	33	26.19	0.056	0.813
壁结节	24	15.69	19	15.08	0.020	0.889
外壁
光滑	82	53.59	65	51.59	0.112	0.738
毛糙	27	17.65	21	16.67	0.047	0.829
棘状突起	5	3.27	8	6.35	1.477	0.224
内容物
无	74	48.37	65	51.59	0.287	0.592
结节	53	34.64	34	26.98	1.888	0.169
液气平	26	16.99	27	21.43	0.883	0.347
邻近胸膜受牵拉	59	38.56	47	37.30	0.047	0.829
引流支气管	43	28.10	51	40.48	4.734	0.030

CT扫描征象	A组(56例)		B组(56例)		χ²值	P值
CT扫描征象	例数	检出率(%)	例数	检出率(%)	χ²值	P值
实变影	19	33.93	15	26.79	0.676	0.411
毁损肺	18	32.14	8	14.29	5.009	0.025
结节/团块影	17	30.36	15	26.79	0.175	0.676
“树芽征”	18	32.14	29	51.79	4.436	0.035
支气管扩张	22	39.29	19	33.93	0.346	0.556
胸腔积液	28	50.00	21	37.50	1.778	0.182
纵隔淋巴结肿大	31	55.36	27	48.21	0.572	0.449
胸廓塌陷	16	28.57	12	21.43	0.762	0.383