Comparation of CT imaging characteristics between non-tuberculous mycobacterium tuberculosis and multi-drug resistant tuberculosis

doi:10.3969/j.issn.1004-583X.2021.06.010

Abstract

Abstract:

Objective To investigate differences of main CT imaging features between non-tuberculous mycobacterium(NTM) tuberculosis and multi-drug resistant tuberculosis(MDR-TB) for the accuracy of differential diagnosis between the two diseases. Methods The differences of general information, CT imaging features, and lesion locations of the patients were compared between the NTM group (n=41) and mDR-TB group (n=38), the patients were all adimitted to our hospital from Jun 2019 to Jun 2020 were selected. Results Age, the proportion of complicated with pulmonary basic diseases in NTM group were higher than those in MDR-TB group, and the course of disease in NTM group was shorter than that in MDR-TB group (P<0.05) ; The lesions in NTM group were more characterized by thin-wall cavity, and the detection rate in NTM group was higher than those in MDR-TB group (P<0.05); The detection rate of thick-wall cavity, pulmonary consolidation,atelectasis, collapsed lung, lung calcification, hilar mediastinal lymph node calcification, lung volume reduction, pleural thickening, the pleural effusion in NTM group were lower than those in MDR-TB group (P<0.05). The proportion of lesions involved in the ligule lobe of left lung and the middle lobe of right lung in the NTM group was higher than that in MDR-TB group (P<0.05); the proportion of cavity involved in the ligule lobe of left lung and the middle lobe of right lung in the NTM group was higher than that in MDR-TB group (P<0.05); the proportion of bronchiectasis involved in the ligule lobe of left lung and the middle lobe of right lung in NTM group was higher than that in MDR-TB group (P<0.05). There was no significant difference in the site of nodule involvement between two groups (P>0.05). Conclusion The imaging features of NTM tuberculosis and MDR-TB are similar, but there are differences, it is easier for the former to detect thin-wall cavity and for the latter to detect thick-wall cavity, atelectasis, collapsed lung, lung calcification and other characteristics, this can provide reference for the differential diagnosis of the two diseases.

Key words: nontuberculous mycobacteria, extensively drug-resistant tuberculosis, tomography, X-ray computed, diagnosis, differential

CLC Number:

Li Chaojun, Sun Chenghong, Jin Wenyu. Comparation of CT imaging characteristics between non-tuberculous mycobacterium tuberculosis and multi-drug resistant tuberculosis[J]. Clinical Focus, 2021, 36(6): 530-534.

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URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2021.06.010

https://huicui.hebmu.edu.cn/EN/Y2021/V36/I6/530

Figures/Tables 6

References 20

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组别	例数	性别[例(%)]			年龄 (岁)		合并肺基础疾病 [例(%)]		病程 (月)		咳嗽 [例(%)]		咳痰 [例(%)]
组别	例数	男	女		年龄 (岁)		合并肺基础疾病 [例(%)]		病程 (月)		咳嗽 [例(%)]		咳痰 [例(%)]
NTM组	41	28(68.29)	13(31.71)		62.59±10.82		27(65.85)		14.12±7.28		29(70.73)		26(63.41)
MDR-TB组	38	24(63.16)	14(36.84)		56.27±12.39		13(34.21)		24.48±9.82		32(84.21)		28(73.68)
t/χ²值		0.231			2.368		7.900		3.883		2.037		0.962
P值		0.631			0.020		0.005		<0.01		0.154		0.327
组别	例数	咯血 [例(%)]		发热 [例(%)]		盗汗 [例(%)]		WBC升高 [例(%)]		Hb降低 [例(%)]		ALB降低 [例(%)]
NTM组	41	11(26.83)		11(26.83)		13(31.71)		17(41.46)		13(31.71)		18(43.90)
MDR-TB组	38	12(31.58)		14(36.84)		8(21.05)		15(39.47)		11(28.95)		15(39.47)
t/χ²值		0.216		0.914		1.147		0.032		0.071		0.159
P值		0.642		0.339		0.284		0.857		0.790		0.690

组别	例数	性别[例(%)]			年龄 (岁)		合并肺基础疾病 [例(%)]		病程 (月)		咳嗽 [例(%)]		咳痰 [例(%)]
组别	例数	男	女		年龄 (岁)		合并肺基础疾病 [例(%)]		病程 (月)		咳嗽 [例(%)]		咳痰 [例(%)]
NTM组	41	28(68.29)	13(31.71)		62.59±10.82		27(65.85)		14.12±7.28		29(70.73)		26(63.41)
MDR-TB组	38	24(63.16)	14(36.84)		56.27±12.39		13(34.21)		24.48±9.82		32(84.21)		28(73.68)
t/χ²值		0.231			2.368		7.900		3.883		2.037		0.962
P值		0.631			0.020		0.005		<0.01		0.154		0.327
组别	例数	咯血 [例(%)]		发热 [例(%)]		盗汗 [例(%)]		WBC升高 [例(%)]		Hb降低 [例(%)]		ALB降低 [例(%)]
NTM组	41	11(26.83)		11(26.83)		13(31.71)		17(41.46)		13(31.71)		18(43.90)
MDR-TB组	38	12(31.58)		14(36.84)		8(21.05)		15(39.47)		11(28.95)		15(39.47)
t/χ²值		0.216		0.914		1.147		0.032		0.071		0.159
P值		0.642		0.339		0.284		0.857		0.790		0.690

组别	例数		累及肺叶(个)						薄壁空洞		厚壁空洞		单发空洞		多发空洞		支气管扩张		肺实变
组别	例数		1~2		3~4		5~6		薄壁空洞		厚壁空洞		单发空洞		多发空洞		支气管扩张		肺实变
NTM组	41		9(21.95)		10(24.39)		19(70.73)		16(39.02)		7(17.07)		1(2.44)		18(43.90)		20(48.78)		10(24.39)
MDR-TB组	38		11(28.95)		12(31.58)		15(39.47)		7(18.42)		15(39.47)		2(5.26)		17(44.74)		17(44.74)		21(55.26)
χ²值					1.462				4.057		4.925		0.431		0.006		0.130		7.884
P值					0.513				0.044		0.026		0.512		0.941		0.719		0.005
组别		例数		肺不张		肺毁损		肺内钙化		肺门纵隔淋巴结钙化		结节		肺体积缩小		胸膜增厚		胸腔积液
NTM组		41		0(0.00)		0(0.00)		10(24.39)		7(17.07)		28(68.29)		4(9.76)		15(36.59)		5(12.20)
MDR-TB组		38		5(13.16)		4(10.53)		27(71.05)		18(47.37)		29(76.32)		13(34.21)		26(68.42)		13(34.21)
χ²值				5.759		4.546		17.246		8.368		0.632		6.983		8.007		5.433
P值				0.016		0.033		<0.01		0.004		0.427		0.008		0.005		0.020

组别	例数		累及肺叶(个)						薄壁空洞		厚壁空洞		单发空洞		多发空洞		支气管扩张		肺实变
组别	例数		1~2		3~4		5~6		薄壁空洞		厚壁空洞		单发空洞		多发空洞		支气管扩张		肺实变
NTM组	41		9(21.95)		10(24.39)		19(70.73)		16(39.02)		7(17.07)		1(2.44)		18(43.90)		20(48.78)		10(24.39)
MDR-TB组	38		11(28.95)		12(31.58)		15(39.47)		7(18.42)		15(39.47)		2(5.26)		17(44.74)		17(44.74)		21(55.26)
χ²值					1.462				4.057		4.925		0.431		0.006		0.130		7.884
P值					0.513				0.044		0.026		0.512		0.941		0.719		0.005
组别		例数		肺不张		肺毁损		肺内钙化		肺门纵隔淋巴结钙化		结节		肺体积缩小		胸膜增厚		胸腔积液
NTM组		41		0(0.00)		0(0.00)		10(24.39)		7(17.07)		28(68.29)		4(9.76)		15(36.59)		5(12.20)
MDR-TB组		38		5(13.16)		4(10.53)		27(71.05)		18(47.37)		29(76.32)		13(34.21)		26(68.42)		13(34.21)
χ²值				5.759		4.546		17.246		8.368		0.632		6.983		8.007		5.433
P值				0.016		0.033		<0.01		0.004		0.427		0.008		0.005		0.020

组别	例数	左肺			右肺
组别	例数	上叶前段及尖后段	上叶舌段	下叶	上叶	中叶	下叶
NTM组	41	24(58.54)	31(75.61)	20(48.78)	31(75.61)	29(70.73)	22(53.66)
MDR-TB组	38	26(68.42)	11(28.95)	22(57.89)	34(89.47)	11(28.95)	23(60.53)
χ²值		0.829	17.246	0.658	2.600	13.775	0.379
P值		0.362	<0.01	0.417	0.107	<0.01	0.538