摘要
目的探讨MSCT联合半乳甘露聚糖含量检测(GM试验)对肺曲霉菌病的诊断价值。方法疑诊131例肺曲霉菌病患者,91例被病理学或痰培养确诊为肺曲霉菌病。回顾性分析其MSCT征象、GM试验结果值并与病理结果对照,进行统计学分析,计算MSCT、GM试验、MSCT和血清GM试验联合诊断肺曲霉菌病的准确度、敏感性、特异性、阳性预测值和阴性预测值。结果91例肺曲霉菌病的CT表现:结节及肿块型46例,病变边缘可见毛刺、分叶征及“晕征”;肺炎实变型18例,表现为片状密度增高影,内见充气支气管,部分周围见“晕征”;空洞型27例,表现单发或多发大小不等空洞性病变,部分病变内可见“空气新月征”,部分空洞周围呈磨玻璃样改变,即“晕征”。MSCT诊断肺曲霉菌病的准确度、敏感性、特异性、阳性预测值和阴性预测值分别是85.05%、89.01%、77.50%、90.00%、75.61%;血清GM试验分别是90.84%、92.31%、87.50%、94.38%、83.33%;MSCT图像和血清GM试验联合分别是93.89%、94.51%、92.50%、96.63%、88.10%;MSCT、血清GM试验、MSCT和血清GM试验联合分别与手术病理结果比较,3组数据有统计学意义(P<0.05)。结论MSCT和GM试验联合可提高肺曲霉菌病诊断的准确度、敏感性、特异性、阳性预测值和阴性预测值,对指导诊疗早期肺曲霉菌病具有重要的临床意义。
Objective:To explore the diagnostic value of MSCT combined with galactomannan content detection(GM test)in pulmonary aspergillosis.Methods:Among the total of 131 patients who were suspected pulmonary Aspergillosis,91 patients were diagnosed with pulmonary Aspergillus infection by pathology and sputum culture.CT Image was analyzed retrospectively,together with the results of GM test.The accuracy,sensitivity,specificity,positive predictive value and negative predictive value of MSCT images and GM test in the diagnosis of pulmonary aspergillosis were calculated.Results:(1)CT manifestations of 91 patients with pulmonary aspergillosis:Forty-six cases were nodular and mass type.And burrs,lobulation and"halo"were seen on the margins of the lesions in these nodular patients.Eighteen patients were the type of substantial change of pneumonia and they showed patchy density enhancement,inflatable bronchus and halo sign around part of them.Twenty-seven cases were cavity type.The manifestations were single or multiple cavitary lesions of varying sizes.The"air crescent sign"could be seen in some lesions,and the ground-glass changes around some of the cavities,namely the"halo sign".(2)The accuracy,sensitivity,specificity,positive predictive value and negative predictive value of MSCT in diagnosing pulmonary aspergillosis were 85.49%,89.01%,77.50%,90.00%and 75.61%,respectively;the serum GM test were 90.84%,92.31%,87.50%,94.38%and 83.33%,the combination of MSCT image and serum GM test were 93.89%,94.51%,92.50%,96.63%and 88.10%,respectively.The combined results of MSCT,serum GM test,MSCT and serum GM test were compared with the surgical pathological results,respectively.Three date sets had significance statistics difference(P<0.05).Conclusion:The combination of MSCT and GM test can improve accuracy,sensitivity,specificity,positive predictive value and negative predictive value of pulmonary aspergillosis,which is of significance to guide the diagnosis and treatment of early pulmonary aspergillosis.
作者
于永梅
YU Yong-mei(Dept.of Radiology,Jining No.1 People's Hospital,Jining 272000,China)
出处
《泰山医学院学报》
CAS
2020年第1期54-58,共5页
Journal of Taishan Medical College
