继发性初治涂阳与涂阴活动性肺结核CT影像对比分析

目的探讨初治涂阳与涂阴活动性肺结核的CT影像特征。方法收集2008年住院治疗的初治涂阳与涂阴肺结核各100例，对比观察两组CT征象的异同点以诊断活动性肺结核有价值的征象。结果小叶中心结节、磨玻璃影、树芽征、空洞征、气道壁增厚、亚段以上实变，涂阳组／涂阴组CT检出率依次为：91％／81％、65％／32％、59％／40％、55％／13％、52％／31％、38％／15％、（P〈0．05），小叶样实变、小叶间内质异常两组为75％／63％、28％／17％，（P〉0．05）；涂阴肺结核病变累及单叶肺为主，涂阳组以多叶受累为主（P〈0．01）；涂阳组各种征象的检出率均明显高于涂阴组。结论涂阴与涂阳活动性肺结核的CT征象没有质的区别，但有量的差异，并需结合临床。

Contrast research of CT manifestations in secondary active pulmonary tuberculosis among patients with positive and negative smear after primary therapy

Objective To explore the value of CT manifestations in the diagnosis of secondary active pulmonary tuberculosis with positive and negative smear among patients after primary therapy. Methods 100 patients with negative smear and the other 100 patients with positive smear who were inpatient during 2008 were scanned by CT examination. Then the differences of CT manifestation and its occurrence between the two groups were observed. At last the helpful signs were picked up. Results The contrast of CT occurrence between smear test ＂ ＋ ＂ group and smear test ＂ - ＂ group showed that the occurrences of lobular nodules, ground-glass opacity, tree-in-bud sign, cavity, thickening of bronchial wall as well as egmental and subsegmental consolidation were 91%/81%, 65 %/32 %, 59 %/40%, 55 % / 13% ,52%/31% and 38%/15% respectively, with statistical significant difference（P 〈0. 05）. And the differences in the lobular consolidation as well as reticular and linear sign between smear ＂ ＋ ＂ and smear ＂ - ＂ were not statistically significant, and the occurrence were 75%/63% and 28%/17% respectively. Single lobe was always involved in the negative smear group, while multiple lobes were involved in the positive smear group, with the statistical significance （P 〈 0. 05 ）. And there were more signs occurred in smear test ＂ ＋ ＂ group. Conclusion There is no quality but quantity difference in CT signs between the smear test ＂ ＋ ＂ group and the smear test ＂ - ＂ group. The part of these signs is helpful in the diagnosis of smear test ＂ - ＂ tuberculosis, which also needs to consider the clinical practice.