Balkan Arzu, Balci Engin, Yüksekol Ismail, Ozkan Metin, Taşan Yücel, Papuşcu Yüksel, Ekiz Kudret, Bilgiç Hayati, Demirci Necmettin, Seber Olgaç
Department of Pulmonary Diseases, Gülhane Military School of Medicine, Ankara, Turkey.
Tuberk Toraks. 2004;52(1):38-46.
In this study we have tried to put forth the role of thorax high resolution computerized tomography (HRCT) in the pursue of the diagnosis and treatment of pulmonary tuberculosis. It was detected that of the 67 patients with active tuberculosis, 66 (98.5%) had centrilobular nodule or branching linear structures, 65 (97%) had acinary nodule, 55 (82%) had consolidation, 55 (82%) had cavities, 54 (80.5%) had tree in bud appearance and 52 (77.6%) were bilateral. Of 30 patients suffering from inactive tuberculosis, 26 (86.6%) were detected to have fibrotic changes, 20 (66.6%) bronchiectasis, 18 (60%) bronchovascular distortion and 14 (46.6%) pericicatrial emphysema. The sensitivity, specificity, positive predictive value, negative predictive values of thorax HRCT in determining the activity of the illness were found as 97%, 86.7%, 94.2% and 92.9% respectively. In conclusion we can say that thorax HRCT is a powerful and reliable diagnostic method for pulmonary tuberculosis. Thorax HRCT can be used as noninvasive diagnostic method especially in the patients suffering from smear and culture negative active tuberculosis.
在本研究中,我们试图阐述胸部高分辨率计算机断层扫描(HRCT)在肺结核诊断和治疗中的作用。结果发现,在67例活动性肺结核患者中,66例(98.5%)有小叶中心结节或分支状线性结构,65例(97%)有腺泡结节,55例(82%)有实变,55例(82%)有空洞,54例(80.5%)有树芽征,52例(77.6%)为双侧病变。在30例非活动性肺结核患者中,26例(86.6%)有纤维化改变,20例(66.6%)有支气管扩张,18例(60%)有支气管血管扭曲,14例(46.6%)有瘢痕旁肺气肿。胸部HRCT在判断疾病活动性方面的敏感性、特异性、阳性预测值、阴性预测值分别为97%、86.7%、94.2%和92.9%。总之,我们可以说胸部HRCT是诊断肺结核的一种强大而可靠的方法。胸部HRCT尤其可作为涂片和培养阴性的活动性肺结核患者的非侵入性诊断方法。