目的 探讨多层螺旋CT(MSCT)平 扫在活动性肺结核临床治疗前、后中的应 用价值。方法 选取2016年12月至2018年8 月我院连续收集的118例活动性肺结核患 者作为研究对象，所有患者均予以抗结 核治疗，治疗前后均行MSCT检查，整理分 析118例活动性肺结核患者的临床及影像 学资料，比较所有患者治疗前后期MSCT检 查图像表现结果。结果 118例活动性肺结 核患者治疗前MSCT检查活动性肺部征象 检出率为100.00%(118/118)，抗结核治 疗后MSCT对其活动性肺部征象检出率为 38.98%(46/118)，比较差异间具有统计学 意义(χ2 =121.026，P<0.001)；整理相关 影像学资料可知，经抗结核治疗后，MSCT 检查示活动性肺结核患者其CT征象中毛玻 璃样影、树芽征、支气管增厚以及节段分 布小叶中心节吸收率均可达80.00%以上， 斑块和球形病灶可见部分吸收，表明肺结 核活动性的不确定，而支气管扩张和纤维 索条及线影治疗前后MSCT检查中其征象表 现未见明显变化，即提示该征象为活动性 肺结核抗结核治疗后结核残留的主要征 象。结论 MSCT可明确显示出活动性肺结 核的病变征象和有利于观察治疗前后其肺 部病变征象的演变和转化情况，更有助于 评估活动性肺结核患者的治疗效果，为其 治疗提供进一步的指导依据。

Objective To explore the application value of multi-slice spiral CT (MSCT) plain scan before and after clinical treatment of active tuberculosis. Methods 118 patients with active tuberculosis collected from our hospital from December 2016 to August 2018 were selected as subjects. All patients were treated with antituberculosis therapy. MSCT was performed before and after treatment. The clinical and imaging data of 118 patients with active tuberculosis were analyzed and compared. The results of MSCT images before and after treatment were compared. Results The detection rate of active pulmonary signs in 106 patients with active tuberculosis before treatment was 100.00% (118/118), and the detection rate of active pulmonary signs in MSCT after antituberculosis therapy was 38.98% (46/118),and the difference was statistically significant (χ2 =121.026, P<0.001). According to the relevant imaging data, after antituberculosis therapyt, the MSCT examination showed that in the CT signs of the patients with active tuberculosis,the absorption rate of shadow like frosted glass, tree-in-bud, bronchial thickening and segmental distribution of leaflet central nodes can reach more than 80.00%, and plaque and spherical lesions were partially absorbed,which indicated the uncertainty of the activity of tuberculosis. However, there was no significant change in the signs of bronchiectasis and fibrous stripes and hachure in MSCT examination before and after treatment, which suggested that this sign was the main sign of residual tuberculosis after antituberculosis therapy. Conclusion MSCT can clearly show the signs of active tuberculosis and it is useful to observe the evolution and transformation of signs lung before and after treatment. It is more helpful to evaluate the therapeutic effect of patients with active tuberculosis and provide further guidance for their treatment.