摘要
目的分析X线胸片诊断肺结核影像临床价值。方法选择自2018年1—12月在该所进行诊断的55例肺结核患者作为研究对象,患者均行X线胸片检查、病理检查,以追踪患者的病原学检查及病理检查结果作为金标准,计算X线胸片对肺结核诊断准确率,并总结肺结核X线胸片影像特征。结果病理检查共诊断出原发性肺结核6例、血型播散性肺结核2例、继发性肺结核47例,X线胸片检查共诊断出原发性肺结核6例、血型播散性肺结核2例、继发性肺结核46例,X线胸片检查对肺结核诊断准确率(98.18%)与病理检查(100.00%)对比差异无统计学意义(χ2=0.152,P>0.05);原发性肺结核X线胸片影像特征为原发病灶可发生在双肺的各段,常见于右上叶,且X线胸片显示,原发病灶、肺门及纵膈淋巴结肿大或单纯的肺门及纵膈淋巴结肿大,病灶边缘模糊,表现为密度不均匀的增高影,可形成不规则、大小不等的空洞,肺门淋巴结多位于原发病灶对同侧,也有部分淋巴结波及对侧,肿大的肺门淋巴结与肺内原发病灶之间常连接条索状影。血型播散性肺结核X线胸片影像特征为两肺弥散分布直径约为1~3 mm的栗粒样结节影,形状为椭圆形或圆形,栗粒病灶大小、分布及密切分布均匀,表现为三均匀状态。继发性肺结核X线胸片影像特征为肺上部浸润灶病,肺部可见结核浸润灶和陈旧性结核灶,常有空洞形成,且肺部常有一定程度片状及斑片阴影。结论对肺结核患者行X线胸片诊断,不仅具有较高的诊断准确率,且能根据X线影像特征鉴别区分出肺结核类型,从而有助于指导临床采取针对性的方案对患者治疗。
Objective To analyze the clinical value of X-ray chest radiography in the diagnosis of tuberculosis.Methods Fifty-five patients with tuberculosis diagnosed in the institute from January to December 2018 were selected as the research subjects.All patients underwent X-ray chest radiographs and pathological examinations to track the results of the pathogenic examination and pathological examination of the patients.As a gold standard,the diagnostic accuracy of X-ray chest radiographs for tuberculosis was calculated,and the characteristics of X-ray chest radiographs were summarized.Results A total of 6 cases of primary tuberculosis,2 cases of blood type disseminated tuberculosis and 47 cases of secondary tuberculosis were diagnosed by pathological examination.A total of 6 cases of primary tuberculosis and blood type disseminated tuberculosis were diagnosed by X-ray chest examination,46 cases of secondary tuberculosis,and the diagnostic accuracy rate of tuberculosis(98.18%) and pathological examination(100.00%) of X-ray chest radiography showed no significant difference,and there was no statistical significance(χ2=0.152,P>0.05);the original X-ray chest radiographs of primary tuberculosis are characterized by primary lesions that can occur in both segments of the lungs,and are common in the right upper lobe.X-ray chest radiographs showed primary lesions,hilar and mediastinal lymph nodes,or simple lungs.The hilar and mediastinal lymph nodes are swollen,the edges of the lesions are blurred,and the density of the lesions was uneven.They can form irregular and sized hollows.The hilar lymph nodes are mostly located on the same side of the original lesion,and some lymph nodes spread to the opposite side,the enlarged hilar lymph nodes and the primary lesions in the lung were often connected by a cable-like shadow.The X-ray chest radiograph of blood-type disseminated pulmonary tuberculosis was characterized by chestnut-like nodules with a diffuse distribution of about 1-3 mm in diameter in both lungs.The shape was oval or roun
作者
李林栋
LI Lin-dong(Liaocheng Chiping District Tuberculosis Control Institute,Liaocheng,Shandong Province,252100 China)
出处
《世界复合医学》
2020年第5期1-3,共3页
World Journal of Complex Medicine
关键词
X线胸片
诊断
肺结核
Chest X-ray
Diagnosis
Tuberculosis
