Research on the Application Value of Low-Dose Spiral CT Examination in the Clinical Differential Diagnosis of Pulmonary Tuberculosis

YANG Hongwei; CHEN Yanyan

doi:10.14033/j.cnki.cfmr.2025.33.018

Abstract：Objective:To explore the application value of low-dose spiral CT examination in the differential diagnosis of pulmonary tuberculosis.Method:A total of 112 patients with suspected pulmonary tuberculosis admitted to the Zhangzhou Municipal Hospital of Fujian from February 2023 to December 2024 were selected and all underwent low-dose spiral CT and X-ray examinations.Taking the results of sputum culture as the"gold standard"for diagnosis,the efficacy of low-dose spiral CT and X-ray examinations in diagnosing pulmonary tuberculosis was analyzed,and the consistency between the two examination methods and the results of sputum culture were also analyzed.The detection rates of imaging features of pulmonary tuberculosis by the two examination methods were compared.Result:Among the 112 suspected patients,87 cases(77.68%)were diagnosed as pulmonary tuberculosis and 25 cases(22.32%)were diagnosed as non-pulmonary tuberculosis through sputum culture examination.The accuracy,negative predictive value and sensitivity of low-dose spiral CT in diagnosing pulmonary tuberculosis were all higher than those of X-ray examination,with statistically significant differences(P<0.05).There was no statistically significant difference between the specificity and positive predictive value of low-dose spiral CT and X-ray in the diagnosis of pulmonary tuberculosis(P>0.05).The consistency test showed that the consistency between the diagnosis results of low-dose spiral CT and those of sputum culture was good(kappa value=0.900,P<0.001).The consistency between the diagnosis results of X-ray and those of sputum culture was acceptable(kappa value=0.676,P<0.001).The detection rates of cavities,bronchial dissemination foci,satellite foci and lymph node enlargement by low-dose spiral CT were higher than those by X-ray,and the differences were statistically significant(P<0.05).Conclusion:With its high resolution,low-dose spiral CT can clearly present the imaging features of pulmonary tuberculosis such as nodules and cavities,has high diagnostic accuracy,which is conducive to early diagnosis and treatment.