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目的探讨涂阴培阳肺结核治疗前后及随访6个月时的MSCT表现及演变规律。方法搜集并筛选2009年6月至2012年1月在本院登记治疗且资料完整的涂阴培阳肺结核82例,由3名有经验的高年资主治以上医师进行阅片,统一意见后逐一记录每个病例的胸部MSCT表现及特点,对比分析治疗前后及随访6个月时的MSCT表现。结果治疗前活动性肺结核MSCT征象中的小叶中心结节、磨玻璃影、腺泡结节、树芽征、边缘模糊的小叶样实变、支气管壁增厚、多发性结节内小空洞、边缘模糊的实变、厚壁空洞检出率分别为78.0%、76.8%、70.7%、50%、45.1%、45.1%、43.9%、19.5%、3.66%;活动性CT征象治疗前后检出率分别为100%、17.1%。治疗后非活动性肺结核MSCT征象中的条索影、边缘清晰高密度结节、肺结构扭曲变形、斑块、钙化、支气管扩张、空腔检出率分别为75.6%、59.8%、41.5%、18.3%、15.9%、12.2%、8.54%;非活动性MSCT征象治疗前后检出率分别为30.5%、90.2%。结论涂阴培阳肺结核MSCT征象及转归和其代表的病变性质有关。疗程结束后病灶进一步吸收,但主要是肺组织自身的重塑过程。
Objective To investigate the appearance and evolution of MSCT before, after, and 6 months of treatment of Tu Yin and Yang positive pulmonary tuberculosis. Methods Eighty-two smear positive pulmonary tuberculosis patients were enrolled and screened in our hospital from June 2009 to January 2012. The data were reviewed by 3 experienced senior physicians and were read one by one after unifying their opinions The performance and characteristics of chest CTCT in each case were recorded. The MSCT findings were compared before and after treatment and at 6 months of follow-up. Results MSCT signs of active pulmonary tuberculosis in the treatment of centrilobular nodules, ground glass, acinar nodules, tree bud levy, edge blurred leaflet-like consolidation, bronchial wall thickening, multiple nodules within the small holes, edge The detection rates of ambiguous consolidation and thick wall were 78.0%, 76.8%, 70.7%, 50%, 45.1%, 45.1%, 43.9%, 19.5% and 3.66% respectively. The detection rates of active CT signs were As 100%, 17.1%. After treatment, the incidence of tuberculosis MSCT signs, sharp edge of high-density nodules, distorted lung structure, plaque, calcification, bronchiectasis, cavity detection rates were 75.6%, 59.8%, 41.5% 18.3%, 15.9%, 12.2% and 8.54% respectively. The detection rates of inactive MSCT before and after treatment were 30.5% and 90.2% respectively. Conclusion The results of smear-positive and-yang-smear-positive pulmonary tuberculosis MSCT and its prognosis are related to the nature of the lesion. Lesions further absorbed after the end of the course of treatment, but mainly remodeling of the lung tissue itself.