继发性肺结核并发真菌感染与单纯继发性肺结核CT表现比较分析

目的分析肺结核并发真菌感染患者CT表现,提高影像诊断能力。方法选取150例确诊的肺结核并发真菌感染患者为观察组;另同期随机抽取痰检阳性150例单纯肺结核患者为对照组;分析比较两组患者病变分布、范围及病变CT表现。结果观察组病变分布广泛,累及≥3个肺叶为44.6%(67/150),大于对照组26.8%(40/150),两组比较差异有统计学意义(χ^2=10.35,P<0.01);观察组CT表现示空洞、新月征及结节、条带影、晕征、胸膜下段叶状实变影、胸腔积液、胸膜增厚粘连发生率分别为56.0%(84/150)、36.0%(54/150)、8.0%(12/150)、59.4%(89/150)、56.0%(84/150)、41.0%(62/150)、54.6%(82/150),高于对照组分别为28.0%(42/150)、5.3%(8/150)、1.3%(2/150)、13.6%(20/150)、18.5%(28/150)、25.4%(38/150)、40.8%(61/150),两组比较差异有统计学意义(分别为χ^2=24.14,P<0.01;χ^2=20.88,P<0.01;χ^2=7.49,P<0.01;χ^2=68.61,P<0.01;χ^2=44.68,P<0.01;χ^2=8.64,P<0.01;χ^2=5.89,P<0.05)。结论肺结核患者合并肺部真菌感染的CT表现具有多肺叶受累,空洞内结节、新月征、条带影、晕征、两肺下叶胸膜下片状实变影、胸腔积液、胸膜增厚粘连发生率高等特点。

Comparative analysis of CT findings of secondary pulmonary tuberculosis complicated with fungal infection and simple secondary pulmonary tuberculosis

Objective To analyze the CT manifestations of patients with pulmonary tuberculosis complicated with fungal infection,so as to improve the imaging diagnosis ability.Methods 150 cases of confirmed pulmonary tuberculosis complicated with fungal infection were selected as the observation group,and 150 cases of pure pulmonary tuberculosis patients with positive sputum test were randomly selected as the control group.The distribution,scope and CT manifestations of lesions in the two groups were analyzed and compared.Results The lesions in the observation group were widely distributed,with 44.6%(67/150)involving 3 or more lung lobes,which was larger than the control group 26.8%(40/150).The difference between the two groups was statistically significant(χ^2=10.35,P<0.01).The CT performance of the observation group showed that hollow,crescent signs and nodules,band shadow,halo signs,pleural leaf consolidation,pleural effusion,pleural thickening and adhesion were 56.0%(84/150),36.0%(54/150),8.0%(12/150),59.4%(89/150),56.0%(84/150),41.0%(62/150),54.6%(82/150),higher than the control group by 28.0%(42/150)150),5.3%(8/150),1.3%(2/150),13.6%(20/150),18.5%(28/150),25.4%(38/150),40.8%(61/150),respectively(χ^2=24.14,P<0.01;χ^2=20.88,P<0.01;χ^2=7.49,P<0.01;χ^2=68.61,P<0.01;χ^2=44.68,P<0.01;χ^2=8.64,P<0.01;χ^2=5.89,P<0.05).Conclusion The CT manifestations of pulmonary tuberculosis patients with pulmonary fungal infection have multiple lobular involvement,cavity nodules,crescent sign,band shadow,halo sign,subpleural plaque consolidation of the lower lobes of both lungs,pleural effusion,and pleural hyperplasia.