摘要
目的探讨初治痰涂片阳性肺结核单发空洞的动态影像演变规律及其在判断疗效和评估预后的临床价值。方法收集100例有单发空洞和获细菌学治愈的初治痰涂片阳性肺结核病例,观察空洞在治疗前、后及随访时的影像学变化。结果①100例初治痰涂片阳性肺结核单发空洞中,影像学表现为厚壁空洞69例(69%),其中洞壁厚薄不均56例(81%),洞壁形态不规则43例(62%);②治疗后单发空洞的转归表现有:闭合消失51例(51%)、纤维疤痕、斑点片状阴影21例(21%),结核球3例(3%)、残留空洞25例(25%);③16例残留空洞的随访中,8例净化薄壁空洞中无明显变化6例(75%),7例纤维硬壁空洞中复发5例(71%),5例复发病例治疗结束时洞壁均有局部增厚,引流支气管均异常,1例张力性空洞时大时小。结论初治痰涂片阳性肺结核单发空洞在抗结核治疗时和随访中,空洞的演变有一定的规律;影像学随访在空洞的动态演变、判断疗效及评估预后方面有重要的临床价值。
Objective To observe the evolution of imaging manifestations of new smear positive pulmonary tuberculosis with single cavity and to analyze its clinical value in therapeutic efficiency and prognosis evaluation. Methods We retrospectively observed the changes of imaging manifestations, during pre-treatment, post treatment and following-up, of 100 cases of new smear positive pulmonary tuberculosis with single cavity patients, who were cured and confirmed by bacteriologic test. Results （1） Among the 100 cases, imaging manifestations were thick-walled cavity in 69 cases （69 %）, with uneven wall thickness in 56 cases （81%） and irregular wall in 43 cases （62 %）; （2） After treatment, the cavity were disap- peared in 51 cases （51%）, turned to fibers scars, spots shadows in 21 cases （21%） and three cases tuberculoma （3%）, residual cavity in 25 cases （25%）; （3）After followed-up, 16 patients with residual cavity, 6 （75 %） in 8 cases with purified thin-wall cavity were not significantly changed; In 7 cases with fibra hard-wall cavity, 5 cases were relapsed and after treatment, the wall of cavity were locally thicker than before and the drainage bronchus were abnormal; Another was tension cavity whose size was variable. Conclusion There are some rules in the evolution of cavities during treatment and following up of new smear positive pulmonary tuberculosis. Medical imaging follow-up has an important clinical value in cavity dynamic evolution, judging the curative effect and prognosis evaluation.
出处
《医学影像学杂志》
2013年第5期710-714,共5页
Journal of Medical Imaging
关键词
肺结核
空洞
体层摄影术
X线计算机
Pulmonary tuberculosis
Cavity
Tomography, X-ray computed.
