Kosaka Nobuyuki, Sakai Toyohiko, Uematsu Hidemasa, Kimura Hirohiko, Hase Mitsuo, Noguchi Masato, Itoh Harumi
Department of Radiology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.
J Comput Assist Tomogr. 2005 Nov-Dec;29(6):801-4. doi: 10.1097/01.rct.0000184642.19421.a9.
This study aimed to evaluate whether high-resolution computed tomography (HRCT) could predict the results of a sputum smear in patients with active pulmonary tuberculosis.
Forty-eight patients with active pulmonary tuberculosis were divided into 2 groups: sputum smear-positive (n = 25) and -negative (n = 23). The HRCT findings were retrospectively reviewed, focusing on the presence or absence of features previously reported to indicate active pulmonary tuberculosis, including ground-glass opacity, cavitation, centrilobular opacity, and air space consolidation.
Although air space consolidation was the least common feature overall, it occurred significantly more frequently in the smear-positive group than in the smear-negative group. This feature also had the highest specificity and positive predictive value. Cavitation and ground-glass opacity also occurred significantly more frequently in the smear-positive group. The frequency of centrilobular opacity did not differ between the 2 groups.
The present study suggested that the HRCT findings of air space consolidation, cavitation, and ground-glass opacity are significantly associated with smear-positive pulmonary tuberculosis.
本研究旨在评估高分辨率计算机断层扫描（HRCT）能否预测活动性肺结核患者的痰涂片结果。
48例活动性肺结核患者分为两组：痰涂片阳性组（n = 25）和阴性组（n = 23）。对HRCT表现进行回顾性分析，重点关注先前报道的提示活动性肺结核的特征的有无，包括磨玻璃影、空洞、小叶中心性实变和肺泡实变。
尽管肺泡实变总体上是最不常见的特征，但在涂片阳性组中出现的频率明显高于涂片阴性组。该特征还具有最高的特异性和阳性预测值。空洞和磨玻璃影在涂片阳性组中出现的频率也明显更高。两组间小叶中心性实变的频率无差异。
本研究表明，肺泡实变、空洞和磨玻璃影的HRCT表现与涂片阳性肺结核显著相关。
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