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基于CT综合评分系统的非结核分枝杆菌肺病的影像学特征及影响因素

Composite CT score-based assessment for comparative analysis of radiological feature and clinical factor in pulmonary non-tuberculous mycobacterial disease

  • 摘要:
    目的 通过CT综合评分系统,探讨我国非结核分枝杆菌肺病影像学特征的影响因素。
    方法 回顾性选择2018年9月至2019年10月复旦大学附属中山医院收治的可疑非结核分枝杆菌肺病患者56例,根据CT分值分为CT分值< 10分组(n=27)和CT分值≥10分组(n=29)。收集临床资料及影像学信息,其中影像学评估采用支气管扩张、出芽征、结节影、实变影、空洞、曲霉球以及肺叶范围的综合评分系统。
    结果 CT分值≥10分组人群年龄高于CT分值< 10分组(65.63±11.2)vs(56.21±14.09)岁,P=0.008,年龄和CT分值具有相关性(r=0.322,P=0.016)。右上中叶、左舌段以及支扩出芽征和CT分值具有相关性,差异有统计学意义(r均>0.7,P < 0.05),其中,左舌叶及支扩出芽征的相关性较强(r=0.73,P < 0.05)。CT分值影响患者病灶吸收率(P=0.037),但可能与年龄混杂因素有关(HR=0.416,P=0.084)。
    结论 肺部严重病变主要与左舌段的支扩出芽病灶有关。高龄是影像学病变严重的危险因素,且与不良预后有关。

     

    Abstract:
    Objective To explore the factors influencing the imaging characteristics of non-tuberculous Mycobacterium lung disease in China by CT composite scoring system.
    Methods A total of 56 patients were retrospectively collected during September 2018 to October 2019 in Zhongshan Hospital, Fudan University with suspicious nontuberculous mucobacteria pulmonary disease (NTM-PD), according to the CT score, it is divided into groups with CT score < 10 (n=27) and groups with CT score ≥ 10 (n=29). Clinical and imaging information were collected, and imaging evaluation intergrated bronchiectasis, tree-in-bud, nodular, consolidation, cavity, aspergilloma and lung segment into scoring system.
    Results Age was significantly increased in the CT score ≥ 10 group (65.63±11.2 vs 56.21±14.09, P=0.008). There was a correlation between age and CT score (r=0.322, P=0.016). CT scores of right upper middle lobe, left tongue segment and tree-in-bud sign were correlated with CT scores increasement with significant difference (all r>0.7, P < 0.05). The correlation between left tongue lobe and tree-in-bud sign was strongly correlated (r=0.73, P=0.05). CT score affected the absorption rate of lesions in patients (P=0.037), but it may be related to confounding factors (HR=0.416, P=0.084).
    Conclusion The severe pulmonary lesions are mainly related to the bronchiectasis and tree-in-bud of left tongue segment. Elderly patients had more severe lung imaging lesions, and the absorption of the lesion was not obvious.

     

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