多层螺旋CT及灌注成像对尘肺合并肺结核的诊断效果

目的:探析多层螺旋CT及灌注成像对尘肺合并肺结核的诊断效果。方法:筛选2018年11月至2020年11月经本院收治尘肺疑似合并肺结核120例患者进行研究,均进行多层螺旋CT影像及肺结核CT灌注成像检查,观察患者CT征象表现,测定并分析灌注成像参数变化,通过比对病理组织学“金标准”,分析单一及联合检查诊断效能。结果:120例尘肺合并肺结核患者,经病理证实尘肺合并肺结核86例,34例仅为单纯性尘肺;采用多层螺旋CT检查,共计有诸如多发性小结节、多发空洞、磨玻璃影、肺实变、树芽征、团块状、管壁增厚、胸膜增厚、支气管扩张及大结节影等10大征象;经CT征型分析,尘肺合并肺结核以结核球型、浸润型及空洞型多见,依次为13例、38例及23例,其他类型共计12例,较少发生;经CT灌注成像,单纯尘肺患者PF、BF及PI参数均高于尘肺合并肺结核,差异有统计学意义(P<0.05);而不同类型肺结核中,浸润型PF、BF值最高,空洞型PF值最低,结核球型BF值最低,经单因素方差分析,差异有统计学意义(P<0.05);多层螺旋CT影像、肺结核CT灌注成像单一及联合诊断Kappa值依次为0.50、0.64及0.79,均具备中高度一致性,以联合诊断一致性最好。结论:多层螺旋CT影像及肺结核CT灌注成像均可获有良好诊断效能,以联合检查诊断效能最佳。且结合临床症状,实时性分析患者CT影响及灌注参数变化,更利于尘肺合并肺结核的检出。

Diagnostic effect of multi-slice spiral CT and perfusion imaging on pneumoconiosis with pulmonary tuberculosis

Objective To explore and analyze the diagnostic effect of multi-slice spiral CT and perfusion imaging on pneumoconiosis with pulmonary tuberculosis.Methods A total of 120 patients with suspected pneumoconiosis and pulmonary tuberculosis admitted to the hospital were screened between November 2018 and November 2020 for research.All of them underwent multi-slice spiral CT imaging and CT perfusion imaging of pulmonary tuberculosis.The CT signs of the patients were observed,and the perfusion imaging parameters were determined and analyzed.By comparing the"gold standard"of histopathology,the diagnostic efficacy of single examination and combined examination was analyzed.Results Among 120 patients with pneumoconiosis complicated with pulmonary tuberculosis,there were 86 cases of pneumoconiosis with pulmonary tuberculosis and 34 cases of simple pneumoconiosis confirmed by pathology.Using multi-slice spiral CT examination,there were a total of 10 sign such as multiple nodules,multiple cavities,ground-glass opacity pulmonary consolidation,tree-in-bud sign,crumby structure,tube wall thickening,pleura thickening,bronchiectasis and large nodule shadow.According to CT Symptoms analysis,pneumoconiosis with pulmonary tuberculosis was mostly in the types of tuberculoma type(13 cases),infiltrating type(38 cases)and cavity type(23 cases),and other types totaled 12 cases which were rare.After CT perfusion imaging,the PF,BF and PI in patients with pneumoconiosis were higher than those in patients with pneumoconiosis complicated with pulmonary tuberculosis(P<0.05).Among different types of pulmonary tuberculosis,PF and BF of infiltrating type were the highest,PF of cavity type was the lowest and BF value of tuberculoma type was the lowest,and one-way analysis of variance showed that the difference was statistically significant(P<0.05).The Kappa values of multi-slice spiral CT imaging,pulmonary tuberculosis CT perfusion imaging and combined diagnosis were 0.50,0.64 and 0.79 in order,all of which had medium to high consistency.The diagnostic consistency was the best in combined diagnosis.Conclusion Both multi-slice spiral CT imaging and CT perfusion imaging of pulmonary tuberculosis have good diagnostic efficacy,and the combined examination has the best diagnostic efficacy.And combined with clinical symptoms,real-time analysis of CT effect and changes in perfusion parameters of patients is more conducive to the detection of pneumoconiosis with pulmonary tuberculosis.