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新发传染病电子杂志

新发传染病电子杂志 ›› 2021, Vol. 6 ›› Issue (4): 311-314.doi: 10.19871/j.cnki.xfcrbzz.2021.04.010

• 论著 • 上一篇    下一篇

两种常见缓慢生长型非结核分枝杆菌肺病的胸部CT征象 比较

陈华1, 方伟军2, 胡锦兴1, 任会丽2, 韩远远2, 梁瑞云2, 陈品儒1   

  1. 1.广州市胸科医院结核内科,广州 510095;
    2.广州市胸科医院影像科,广州 510095
  • 收稿日期:2021-06-23 出版日期:2021-11-30 发布日期:2021-12-13
  • 通讯作者: 方伟军,Email：fangweijun9@sohu.com
  • 基金资助:
    广东省医学科学技术研究基金项目（C2021090）

Comparison of chest CT features of two kinds of common slow growing nontuberculous mycobacterial pulmonary diseases

Chen Hua1, Fang Weijun2, Hu Jinxing1, Ren Huili2, Han Yuanyuan2, Liang Ruiyun2, Chen Pinru1   

  1. 1. Department of Tuberculosis, Guangzhou Chest Hospital,Guangzhou 510095, China;
    2. Imaging Department, Guangzhou Chest Hospital,Guangzhou 510095, China
  • Received:2021-06-23 Online:2021-11-30 Published:2021-12-13

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摘要： 目的 分析两种常见缓慢生长型非结核分枝杆菌肺病的胸部CT特点,提高其影像学征象的认识。方法 收集2018年1月至2020年12月广州市胸科医院诊治的63例堪萨斯分枝杆菌肺病患者(A组)和60例鸟-胞内分枝杆菌复合群(MAC)肺病患者(B组),两组患者均符合非结核分枝杆菌肺病诊断标准,回顾性分析两组患者的胸部CT征象。结果 ①B组的女性比例、年龄,合并支气管扩张比例显著高于A组,差异均有统计学意义（均P<0.05）。②A组柱状型支气管扩张占比为21.74%（10/46）,B组为48.15%（26/54）;A组囊状型支气管扩张占比为43.48%（20/46）,B组为22.22%（12/54）,差异均有统计学意义（P<0.05）。③B组中40例（74.07%）患者表现为右中叶支气管扩张和38例（70.37%）表现为左舌段支气管扩张;两组比较差异有统计学意义（t=5.881,P=0.002）。④A组肺实变（30.16%）、空洞（76.19%）,空洞中的虫蚀空洞（18.75%）及厚壁空洞（31.25%）明显高于B组;B组树芽征（65.00%）、磨玻璃影（16.67%）及并发的胸膜增厚比例（23.33%）明显高于A组,差异均有统计学意义（P<0.05）。结论 堪萨斯肺病CT征象以柱状支气管扩张、两肺磨玻璃斑片影及肺实变为特征性,而MAC肺病以囊状支气管扩张、微结节（树芽征）为特征性,累及肺叶范围广、分布分散。堪萨斯分枝杆菌肺病与MAC肺病的CT征象均具有各自的特征性。

关键词: 非结核分枝杆菌, 肺, 鸟-胞内分枝杆菌复合群, X线计算机,体层摄影术

Abstract: Objective To analyze the chest CT features of two kinds of common slow growing nontuberculous mycobacterial pulmonary diseases and improve the understanding of their imaging signs. Methods 63 patients with pulmonary disease caused by Mycobacterium Kansas (group A) and 60 patients with pulmonary disease caused by Mycobacterium avium cytoplasmic complex (MAC) (group B) in Guangzhou chest hospital from January 2018 to December 2020 were collected. The two groups of patients met the diagnostic criteria for pulmonary disease caused by nontuberculous Mycobacterium. The CT signs of group A and group B were retrospectively analyzed. Results ①The proportion of women, age and the proportion of bronchiectasis in group B were significantly higher than those in group A (all P<0.05). ②Columnar bronchiectasis accounted for 21.74% (10/46) in group A and 48.15% (26/54) in group B; The percentage of cystic bronchiectasis was 43.48% (20/46) in group A and 22.22% (12/54) in group B (P<0.05). ③In group B, 40 cases (74.07%) showed right middle lobe bronchiectasis and 38 cases (70.37%) showed left lingual bronchiectasis; There was significant difference between the two groups (t = 5.881, P= 0.002). ④In group A, consolidation (30.16%), cavity (76.19%), wormhole (18.75%) and thick walled cavity (31.25%) were significantly higher than those in group B; The tree bud sign (65.00%), ground glass shadow (16.67%) and pleural thickening rate (23.33%) in group B were significantly higher than those in group A (P<0.05). Conclusion The CT signs of Kansas lung disease are characterized by columnar bronchiectasis, ground glass patch shadow of both lungs and lung consolidation, while MAC lung disease is characterized by cystic bronchiectasis and micronodule (tree bud sign), involving a wide range of lung lobes and scattered distribution. The CT signs of Kansas lung disease and MAC lung disease have their own characteristics.

Key words: Nontuberculous mycobacteria, Lung, Avian intracellular Mycobacterium complex, Computed tomography

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