The value of high resolution CT in the diagnosis and treatment of nontuberculous mycobacterial pulmonary diseases

doi:10.3969/j.issn.1000-6621.2018.12.024

Abstract

Abstract:

Retrospective analysis high resolution computed tomography (HRCT)of 99 cases of patients with non-tuberculous mycobacteria (NTM) lung disease in Guangzhou Chest Hospital from March 2015 to September 2017. The location, number, shape, size,density, border and distribution of lung lesions and lymph nodes were analysed and HRCT findings before and after treatment was evaluated.The common signs of HRCT in NTM lung disease were spotty effusion and consolidation in 93 cases, bronchiectasis in 78 cases, cavitary in 60cases,59 cases of fiber shade,58 cases of nodules, tree-in-bud pattern in 55 cases,grinded glass shadow in 46 cases,45 cases of lymphadenopathy,pleural thickening in 18 cases,pleural effusion in 9 cases, multiple forms was usually observed in one patient’s HRCT. Ninety-one patients with NTM lung disease were treated with clarithromycin, rifampicin, ethambutol and amikacin for 6-18months;8 patients underwent lobectomy after precise localization by HRCT and the lesions were significantly reduced after operation but there were pleural thickening adhesions. Chest HRCT plays an important role in the diagnosis and treatment of NTM lung disease.

Key words: Mycobacterium infections, atypical, Lung diseases, Tomography, X-ray Computer, Disease characteristics, Data description, statistics

LIN Xue,JIA Hui-jun,ZHANG Hui,REN Hui-li,LIU Wen. The value of high resolution CT in the diagnosis and treatment of nontuberculous mycobacterial pulmonary diseases[J]. Chinese Journal of Antituberculosis, 2018, 40(12): 1361-1365. doi: 10.3969/j.issn.1000-6621.2018.12.024

Figures/Tables 4

References 18

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HRCT表现	女(61例)	男(38例)	χ²值	P值
斑点或斑片状影	60(98.4)	36(94.7)	1.046	0.306
纤维条索状影	36(59.0)	23(60.5)	0.022	0.882
结节状影	38(62.3)	20(52.6)	0.901	0.342
钙化影	17(27.9)	9(23.7)	0.148	0.700
树芽征	34(55.7)	21(55.3)	0.002	0.963
磨玻璃样影	26(42.6)	20(52.6)	0.943	0.332
粟粒状影	2(3.3)	0(0.0)	-	0.522
空洞	41(67.2)	19(50.0)	2.906	0.088
薄壁空洞	30(49.2)	16(42.1)	0.471	0.492
厚壁空洞	11(18.0)	3(7.9)	1.982	0.159
空洞周围浸润病灶	9(14.8)	2(5.3)	2.135	0.144
空洞内真菌球形成	1(1.6)	0(0.0)	-	1.000
支气管扩张	50(82.0)	28(73.7)	0.961	0.327
气管和(或)支气管狭窄	2(3.3)	0(0.0)	-	0.522
胸膜增厚	14(23.0)	4(10.5)	2.430	0.119
胸腔积液	8(13.1)	1(2.6)	3.314	0.078
纵隔、肺门淋巴结肿大	32(52.5)	13(34.2)	3.145	0.076
心包积液	1(1.6)	0(0.0)	-	1.000

HRCT表现	≥50岁(64例)	<50岁(35例)	χ²值	P值
斑点或斑片状影	63(98.4)	33(94.3)	1.327	0.249
纤维条索状影	38(59.4)	21(60.0)	0.004	0.952
结节状影	39(60.9)	19(54.3)	0.413	0.521
钙化影	19(29.7)	7(20.0)	1.097	0.295
树芽征	33(51.6)	22(62.9)	1.169	0.280
磨玻璃样影	27(42.2)	19(54.3)	1.331	0.249
粟粒状影	2(3.1)	0(0.0)	-	0.538
空洞	42(65.6)	18(51.4)	1.910	0.167
薄壁空洞	32(50.0)	14(40.0)	0.910	0.634
厚壁空洞	10(15.6)	4(11.4)	0.328	0.567
空洞周围浸润病灶	9(14.1)	2(5.7)	1.597	0.206
空洞内真菌球形成	1(1.6)	0(0.0)	-	1.000
支气管扩张	53(82.8)	25(71.4)	1.755	0.185
气管和(或)支气管狭窄	2(3.1)	0(0.0)	-	0.538
胸膜增厚	14(21.9)	4(11.4)	1.660	0.198
胸腔积液	7(10.9)	2(5.7)	0.747	0.387
纵隔、肺门淋巴结肿大	33(51.6)	12(34.3)	2.724	0.099
心包积液	1(1.6)	0(0.0)	-	1.000