摘要
Abstract
Objective To analyze the imaging features,diagnostic value and influencing factors of misdiagnosis and missed diagnosis of multi-slice spiral computed tomography(MSCT)in patients with non-tuberculous mycobacterial(NTM)lung disease(NTM-LD).Methods From January 2022 to January 2024,128 patients with suspected NTM-LD were selected and underwent MSCT and pathological examination.According to the results,the patients were divided into misdiagnosis and missed diagnosis group and correct diagnosis group,and MSCT imaging and characteristics of misdiagnosed cases in the two groups were analyzed.Multivariate logistic regression analysis of the factors affecting the misdiagnosis and missed diagnosis of NTM-LD was performed,and latent class analysis(LCA)was used to compare the differences in the distribution characteristics of factors.Results Among the 128 suspected patients,94 patients were pathologically confirmed,and MSCT detected 89 NTM-LD patients.Using the pathological result as the standard,the detection rate of MSCT was86.17%(81/94),the missed diagnosis rate was13.83%(13/94),and the misdiagnosis rate was 8.51%(8/94).The proportion of pleural thickening,emphysema,lung destruction,enlarged lymph node and pleural effusion in misdiagnosis and missed diagnosis group was significantly higher than that in correct diagnosis group,and the proportion of pneumothorax in misdiagnosis and missed diagnosis group was significantly lower than that in correct diagnosis group(P＜0.05,P＜0.01).Multivariate logistic regression analysis showed that pleural thickening,emphysema,lung destruction,lymph node enlargement,pleural effusion and pneumothorax were influencing factors of the diagnosis of NTM-LD(P＜0.05).LCA showed that the influence of the above factors on the misdiagnosis and missed diagnosis of NTM-LD was heterogeneous.Conclusion The clinical symptoms of NTM-LD patients and pulmonary tuberculosis are similar to CT images,which is prone to misdiagnosis.MSCT has good diagnostic value in the diagnosis of NTM-LD.Pleural thickening,emphysema,lung destruction,lymph node enlargement,pleural effusion and pneumothorax are important influencing factors for the misdiagnosis and missed diagnosis of NTM-LD.关键词
非结核分枝杆菌/体层摄影术,螺旋计算机/病理/误漏诊/结核,肺/肺气肿/胸腔积液/气胸Key words
Nontuberculous mycobacteria/Tomography,spiral computed/Pathology/Misdiagnosis and missed diagnosis/Tuberculosis,pulmonary/Pulmonary emphysema/Pleural effusion/Pneumothorax分类
临床医学
