CT检查在活动性肺结核治疗中的应用价值(1)
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[摘要] 目的 探讨成人活动性肺结核治疗前后的CT征象演变。 方法 连续收集活动性肺结核患者138例，在抗结核治疗前后分别行螺旋CT检查，对比观察肺结核CT征象的转归表现。 结果 本组病例中提示肺结核活动性的CT征象均具有很高的检出率。经过抗结核治疗后，磨玻璃影、空洞、肺实变、树芽征、模糊结节、气道壁增厚、网状微结节吸收率均超过85%。治疗前后上述征象的检出率差异有高度统计学意义(P < 0.01)。纤维结节和纤维条索影为活动性肺结核治愈后的主要CT转归征象。 结论 CT检查有助于活动性肺结核治疗后病变转归的观察，可作为其治疗效果评价的影像学方法。
[关键词] 肺结核；抗结核治疗；活动性；X线计算机；体层摄影
[中图分类号] R521 [文献标识码] A [文章编号] 1673-7210(2012)04(a)-0113-03
Application value of CT examination in the treatment of active pulmonary tuberculosis
LI Yixia1 ZHANG Guoqing2 ZHANG Guannan2 LU Xiwei2▲
1.Department of Outpatient, PLA Navy General Hospital, Beijing 100048, China; 2.Dalian City Tuberculosis Hospital, Liaoning Province, Dalian 116033, China
[Abstract] Objective To discuss the evolution of CT signs before and after treatment of adult active pulmonary tuberculosis. Methods 138 patients with active pulmonary tuberculosis were collected continuously. The spiral CT scan was performed before and after the treatment of anti-tuberculosis. The prognosis of CT signs of pulmonary tuberculosis was observed and compared. Results During the cases of this group, the detection rate of CT signs that showed pulmonary tuberculosis activity was high. After the treatment of anti-tuberculosis, the absorption rates of ground-glass opacity, cavitation, consolidation of lung, tree in bud, fuzzy nodules, thickening of bronchial walls and absorption rate of reticulated micro nodules were all more than 85% after the treatment. There were highly statistically significant differences of detection rate of the CT signs above before and after treatment (P < 0.01). The mainly CT prognosis signs after the active pulmonary tuberculosis was cured were fiber nodules and fiber cord. Conclusion CT examination is helpful for the observation of the prognosis after the treatment of anti-tuberculosise, which can be a radiology method for the evaluation of treatment effectiveness.
[Key words] Pulmonary tuberculosis; Anti-tuberculosis treatment; Active; X-ray computer; Tomography
尽管胸部X线平片是活动性肺结核治疗观察的主要影像学方法，但存在较高的误诊率和不确定性。随着螺旋CT的普及和应用，在成人活动性肺结核诊断和治疗中的作用与地位日益凸显，不仅某些CT征象可作为活动性肺结核的判断依据，而且在抗结核治疗后病变演变的随访过程中起着重要的作用，但类似的对照研究国内尚较少见[1-5]。本研究通过对138例活动性肺结核治疗前后CT征象的对比观察，探讨其征象演变规律及CT判定疗效的临床应用价值。
1 资料与方法
1.1 一般资料
连续收集经结核病专科治疗机构登记和证实的成人活动性肺结核138例 ......
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