64排螺旋CT对肺结核合并CPA的影像学特征及动态疗效评估

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中图分类号：R445 文献标识码：A 文章编号：1001-8751（2025）02-0085-06

Imaging Characteristics and Dynamic Effcacy Assessment of Tuberculosis Combined with CPA by 64-row Spiral CT

He Ping，Lu Xiao-li （PublicHealthClinical CenterofChengdu，Chengdu 610061）

Abstract： ObjectiveThe objective of this paper was to retrospectively analyze the characteristics ofCT signs before and after antifungal therapy in tuberculosis combined with chronic pulmonary aspergilosis （CPA），and to explore the value of antifungal drug therapy.MethodsThe clinical data and CT sign characteristics of 65 patients with pulmonary tuberculosis combined with CPA diagnosed inour hospital were retrospectively analyzed （including 25 cases with data afterantifungal treatment）.Results1.53ofthe 65 patients were single，with a totalof79 lesions， all of which showed cavities and intracavitary nodules， with 28 （35.44%） thin-walled cavities and 51 （64.56%） thickwalled cavities； the'air in bulb sign'was seen in 26 （32.91%） ）of the nodules，and the 'air ring' sign was seen in the periphery of 22 （29.11%） .26 （32.91% ）were surrounded by the 'air ring sign'， 26 （32.91%） were surrounded by the 'air crescent sign'， 9 （11.39% ）weresurroundedby the 'ball sign'，12 （15.19%） ）were surrounded by the 'ball sign'， and 12 （ （15.19%） weresurrounded bythe'aircrescent sign'. 15.19% weresurrounded bythe 'bead sign'.2.When 25 patients were reviewed after receiving antifungal treatment for two weeks to three months，the size of the lesions differed statistically significantly from 40 patients who did not receive antifungal treatment （ Z=-1.998 P=0.046 ）.of these，14 patients （56.00%） had unchanged lesions，9 shrunken lesions，and 2 enlarged lesions，whereas 27 patients （204号 （67.50%） had unchanged lesions，6 shrunken lesions，and 7 enlarged lesions.Conclusion Tuberculosis combined with CPA has characteristic CTmanifestations，which can be combined with imaging features for earlydiagnosis and efcacy assssment，andearlyantifungal treatmentcaneffectivelycontrol thedevelopmentof thelesion，allviate the symptoms of the patients，and improve the prognosis.

Key words： 64-row CT； CPA； tuberculosis； efficacy； dynamics

肺结核病仍是一种传染性极强的呼吸道疾病，也是全球范围内较大公共卫生问题[1-2]。（剩余7832字）