不典型性肺结核影像学诊断价值研究.docVIP

不典型性肺结核的影像学诊断价值研究 　　【摘要】 目的：研究联合应用X线与CT扫描在不典型性肺结核临床诊断方面的价值。方法：纳入研究对象为研究者所在3家医院自2012年1月-2016年12月确诊收治的不典型性肺结核患者共82例，对患者临床资料进行回顾性分析。所有患者均先后进行X线以及CT检查，安排2名以上经验丰富的影像学医师共同阅片。以病理检查结果为金标准，对比X线与CT诊断不典型肺结核的准确率。结果：以病理检查结果为金标准，82例患者中共12例患者为混合型肺结核，55例患者为干酪型肺结核，15例患者为肿块型肺结核。CT联合X线对不典型肺结核的诊断准确率为97.56%（80/82），显著高于单用X线、单用CT的诊断准确率，差异均有统计学意义（P0.05）。结论：CT、X线这两种诊断方法对不典型性肺结核的临床诊断均有一定局限性，需将CT扫描与X线相结合，通过仔细总结与辨认，以得到对不典型性肺结核的准确诊断结果，相互弥补不足，提高与病理诊断结果的符合性，避免漏诊、误诊等问题的产生。 　　【关键词】 不典型性肺结核； CT； X线； 诊断 　　【Abstract】 Objective：To study the value of combined application of X-ray and CT scanning in the clinical diagnosis of atypical pulmonary tuberculosis.Method：82 cases of atypical pulmonary tuberculosis admitted to our hospital from January 2012 to December 2016 were enrolled in this study，the clinical data of the patients were analyzed retrospectively.All the patients underwent X-ray examination and CT examination successively，and more than 2 experienced imaging physicians were invited to read them together.The accuracy of X-ray and CT in the diagnosis of atypical pulmonary tuberculosis was compared with the results of pathological examination as the gold standard.Result：According to the gold standard of pathological examination，82 patients were 12 cases of mixed pulmonary tuberculosis，55 cases of caseous pulmonary tuberculosis，15 cases of mass type of pulmonary tuberculosis.The diagnostic accuracy of CT combined with X-ray of atypical pulmonary tuberculosis was 97.56%（80/82），significantly higher than that with single X-ray and CT diagnostic accuracy，the differences were statistically significant（P0.05）.Conclusion：CT and X-ray of these two kinds of diagnostic methods for no typical clinical diagnosis of tuberculosis all have certain limitations，should be combined with X-ray and computed tomography（CT） scan，through careful summary and identification， in order to get the accurate diagnosis results of no atypical tuberculosis， compensate each other， improve compliance with the pathological diagnosis