肺瘢痕癌的CT诊断及误漏诊分析  

CT findings and misdiagnostic analysis of lung scar carcinoma

作　　者：周长友[1] 林旭波[2] 何家维[2] 张桂艳[2] 

机构地区：[1]上海交通大学医学院苏州九龙医院放射科,江苏苏州215021 [2]温州医学院附属第二医院放射科,浙江温州325000

出　　处：《实用肿瘤杂志》2012年第3期290-293,共4页Journal of Practical Oncology

摘　　要：目的探讨肺瘢痕癌的CT表现,分析其误诊原因,以便提高早期诊断率。方法回顾性分析经病理或临床随访证实的31例肺瘢痕癌的CT表现。结果 31例瘢痕癌均为单发病灶,位于左上肺12例,左下肺3例,右上肺8例,右下肺5例,右肺中叶2例,同时累及右上下肺1例。31例患者X线诊断肺癌8例,误诊率74.2%(23/31);CT首次检查,主要表现纤维条索状,或模糊斑片状,或不成形云雾样阴影,或结节状及球形病灶等,准确诊断15例,误诊率为51.6%(16/31),早期病灶主要误诊为陈旧性或活动性肺结核、结核球、慢性感染、肺纤维化等。结论肺瘢痕癌因与原有瘢痕组织部位重叠、影像学表现相似而容易误诊,密切注意患者的临床症状及病灶的CT影像变化,有助于提高早期诊断。Objective To investigate the CT findings and misdiagnostic reasons of the lung scar carcinoma in order to improve its early diagnosis.Methods The CT findings in 31 cases with lung scar carcinoma,confirmed by pathology and clinical follow-up,were retrospectively analyzed in this study.Results There was only one lesion of lung scar carcinoma in each case.Among the 31 lesions,12 were located at the left upper lobe,3 at the left lower lobe,8 at the right upper lobe,5 at the right lower lobe,2 at the right middle lobe,1 at the right upper lobe and lower lobe.According to the radiograph of 31 lesions,8 cases were diagnosed as lung carcinoma（diagnosis rate,25.8%）,and 23 cases were misdiagnosed as other diseases（misdiagnosis rate,74.2%）.On the CT imaging,the lesions mainly showed funicular,fuzzy patchy,formless cloudy shadow,nodular,spherical and so on.Only 15 cases were correctly diagnosed on CT images（diagnosis rate,48.4%）,and 16 cases were misdiagnosed（misdiagnosis rate,51.6%）.Early lesions were mainly misdiagnosed as old or active pulmonary tuberculosis,tuberculoma,chronic infection,and so on.Conclusions Lung scar carcinoma is easily misdiagnosed because of the overlap and similar imaging finding of the original scar tissue.Early diagnosis can be improved if paying more attention to the clinical symptoms of the patients and the changes of CT findings of the lesions.

关 键 词：肺肿瘤 瘢痕癌 肺结核 体层摄影术 X线计算机 诊断 误诊 

分 类 号：R734.2[医药卫生—肿瘤]