Nam Kyung Jin, Jeong Yeon Joo, Kim Yeong Dae, Kim Kun-Il, Lee Jun Woo, Park Hye Kyung, I Hoseok
Department of Radiology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Pusan, Korea.
Acta Radiol. 2012 Nov 1;53(9):1014-9. doi: 10.1258/ar.2012.120413. Epub 2012 Sep 19.
Determination of disease activity of chronic destructive pulmonary tuberculosis (TB) on imaging studies can be difficult because several imaging findings due to disease chronicity such as a residual cavity can be misinterpreted as an active disease.
To evaluate computed tomography (CT) findings to predict active disease in patients with chronic destructive pulmonary TB.
CT findings of 36 patients with chronic active destructive pulmonary TB and 78 patients with chronic inactive destructive pulmonary TB were reviewed and their patterns of lung lesions were compared. Statistical comparisons were performed using chi-square and Student's T tests for univariate analyses, and a stepwise logistic regression method was used for multivariate analysis.
Based on univariate analyses, cavitary destruction (P = 0.015), non-branching centrilobular nodules (P < 0.001), tree-in-bud pattern (P < 0.001), airspace nodules (P < 0.001), and cavities in other lobes (P = 0.001) were more frequently seen in chronic active destructive pulmonary TB. A stepwise logistic regression analysis demonstrated that tree-in-bud pattern (odds ratio, 52.3; 95% confidence interval, 6.2-437.2; P < 0.001) were significant CT findings associated with active disease.
Tree-in-bud pattern were the most characteristic CT findings to predict active disease in patients with chronic destructive pulmonary TB.
在影像学研究中，确定慢性破坏性肺结核（TB）的疾病活动度可能具有挑战性，因为疾病慢性化导致的一些影像学表现，如残留空洞，可能会被误诊为活动性疾病。
评估计算机断层扫描（CT）表现，以预测慢性破坏性肺结核患者的活动性疾病。
回顾了36例慢性活动性破坏性肺结核患者和78例慢性非活动性破坏性肺结核患者的CT表现，并比较了他们的肺部病变模式。采用卡方检验和学生t检验进行单因素分析的统计学比较，并采用逐步逻辑回归方法进行多因素分析。
基于单因素分析，空洞性破坏（P = 0.015）、非分支小叶中心结节（P < 0.001）、树芽征（P < 0.001）、气腔结节（P < 0.001）和其他肺叶空洞（P = 0.001）在慢性活动性破坏性肺结核中更常见。逐步逻辑回归分析表明，树芽征（优势比，52.3；95%置信区间，6.2 - 437.2；P < 0.001）是与活动性疾病相关的显著CT表现。
树芽征是预测慢性破坏性肺结核患者活动性疾病最具特征性的CT表现。
