摘要
目的糖尿病患者肺炎克雷伯杆菌肝脓肿并发血源性肺部感染CT征象并进行多因素Logistic回归分析。方法回顾性分析经病理证实糖尿病患者肺炎克雷伯杆菌肝脓肿并发血源性肺部播散感染(DKLA-HP)与大肠埃希菌肝脓肿并发血源性肺部播散(ECLA-HP)的临床资料及薄层CT影像学表现,采用逐步法Logistic分析并计算不同阳性CT征象及其联合在DKLA-HP诊断中的敏感度和特异度,最终得出诊断DKLA-HP有统计学意义的影像学征象。结果多因素Logistic回归分析显示近胸膜处结节或伴空洞结节灶、滋养血管征、反晕征更常见于DKLA-HP。三种阳性单一征象中,近胸膜处结节或伴空洞结节灶敏感度最高,反晕征特异度最高,两种联合征象中,近胸膜处结节或伴空洞结节灶+滋养血管征敏感度最高,滋养血管征+反晕征特异度最高,3种征象联合时,敏感度及特异度分别为86.37%、87.28%。结论近胸膜处结节或伴空洞结节灶、滋养血管征、反晕征在DKLA-HP的诊断中具有重要价值,多种征象联合观察能有效提高DKLA-HP诊断的特异度,从而提高DKLA-HP诊断的准确性。
Objective CT signs of Klebsiella pneumoniae hepatic abscess complicated with hematogenous pulmonary infection in diabetic patients were analyzed by multivariate logistic regression.Methods the clinical data and thin-layer CT imaging findings of Klebsiella pneumoniae liver abscess complicated with blood borne pulmonary disseminated infection (dkla-hp) and Escherichia coli liver abscess complicated with blood borne pulmonary dissemination (ecla-hp) were retrospectively analyzed.The corresponding CT signs were analyzed by stepwise logistic method,and the sensitivity of different positive CT signs and their combination in the diagnosis of dkla-hp was calculated Finally,the imaging signs of dkla-hp with statistical significance were obtained.Results Multivariate logistic regression analysis showed that nodules near the pleura or with cavitary nodules,trophoblastic vessel sign and retrohalo sign were more common in dkla-hp.Among the three positive single signs,the sensitivity of nodules near pleura or nodules with cavity was the highest,and the specificity of anti halo sign was the highest.Among the two combined signs,the sensitivity of nodules near pleura or nodules with cavity + trophoblastic vessels was the highest,and the specificity of trophoblastic vessel sign + anti halo sign was the highest.When the three signs were combined,the sensitivity and specificity were 86.37% and 87.28% respectively.Conclusion Proximal pleural nodules or nodules with cavities,trophoblastic signs and anti-halo signs play an important role in the diagnosis of DKLA-HP.Combined observation of multiple signs can effectively improve the specificity of DKLA-HP diagnosis and thus improve the accuracy of DKLA-HP diagnosis.
作者
王军大
杨华
赵建宁
张俊娜
杨雅淋
李艳艳
萧勇
WANG Jun-da;YANG Hua;ZHAO Jian-ning(Department of Radiology,Chongqing Hospital of Traditional Chinese Medicine,Chongqing 400021,China)
出处
《中国CT和MRI杂志》
2020年第9期69-72,共4页
Chinese Journal of CT and MRI
基金
重庆市2018年科卫联合中医药科技项目(ZY201802025)。
关键词
糖尿病患者肺炎克雷伯杆菌肝脓肿并发血源性肺部感染
CT
多因素分析
Diabetic Patients with Klebsiella Pneumoniae Liver Abscess Complicated by Hematogenous Pulmonary Infection
CT
Multivariate Analysis
