肺结核的影像诊断及活动性评价

目的分析肺结核的影像特征，探讨薄层CT对其活动性的评价。方法对2011年3月～2013年3月本院收集的97例肺结核患者的临床资料进行回顾性分析，所有患者均进行影像学检查。根据患者的病变活动性情况将其分为活动组（69例）与非活动组（28例），比较两组结节、微结节、空洞、肿块、支气管异常等情况的差异。结果活动组患者常见的CT表现有。59例（85．51％）存在小叶中央性微结节，37例（53．62％）存在腺泡样微结节，31例（44．93％）存在未钙化结节，41例（59．42％）存在肺实变，42例（60．87％）存在支气管扩张，31例（44．93％）存在磨玻璃影，24例（34．78％）存在厚壁空洞，16例（23．19％）存在支气管壁不均匀增厚伴管腔狭窄；非活动组患者常见的CT表现有，2l例（75．00％）存在小叶中央性微结节，19例（67．86％）存在腺泡样微结节，22例（78．57％）存在钙化性结节，17例（60．71％）存在支气管扩张，20例（71．43％）存在不规则线状影，13例（46．43％）存在瘢痕周围肺气肿，7例（25．00％）存在支气管壁均匀增厚伴管腔狭窄；两组除小叶中央性微结节及支气管扩张外，其他CT表现差异有统计学意义（P〈0．05）。两组病灶多位于右肺上叶后段和尖段，差异无统计学意义（P〉0．05）。结论活动性肺结核与非活动性肺结核具有相似的影像学表现，但两者也存在区别。利用薄层CT扫描仔细区分交互影响因素能准确区分活动性和非活动性肺结核。

Imaging diagnosis and activity evaluation of tuberculosis

Objective To analyze the imaging characteristic of tuberculosis and observe the evaluation of thin-layer CT on activity.Methods The clinical data of 97 patients with tuberculosis treated in our hospital from March 2011 to March 2013 were analyzed retrospectively,all patients received imaging inspection.According to the disease activity,the patients were divided into two groups,activity group for 69 cases and inactivity group for 28 cases.The node,micronodules,cavity,bump and bronchus of two groups were analyzed and compared.Results The common CT findings of activity group were 59 cases （85.51%） of lobular central micro-nodules,37 cases （53.62%） of acinar-like micro-nodules,31 cases （44.93%） of non-calcified nodules,41 cases （59.42%） of lung,42 cases （60.87%） of bronchiectasis,31 cases （44.93%） of ground-glass opacities,24 cases （34.78%） of thick voids,16 cases （23.19%） of bronchial wall thickening with luminal narrowing uneven;The common CT findings of inactivity group were 21 cases （75.00%） of lobular central micro-nodules, 19 cases （67.86%） of acinar-like micro-nodules,22 cases （78.57%） of calcified nodules,17 cases （60.71%） of bronchiectasis,20 cases （71.43%） of irregular linear shadow,13 cases （46.43%） of scars around emphysema,7 cases （25.00%） of bronchial wall thickening with stenosis uniform;the incidence of the performance in addition to micro- nodules outside central lobular and bronchiectasis between the two groups had significant difference （P〈0.05）.The lesions of two groups located in the right upper lobe posterior segment and apical segments,had no significant difference （P〉0.05）.Conclusion Active tuberculosis and inactive tuberculosis has similar imaging performance,but there is no evident difference between them.Applying thin-layer CT scan to differentiate reciprocal influence factors can differentiate active tuberculosis and inactive tuberculosis accurately.