不典型肺炎性假瘤的CT诊断  

CT Diagnosis of Atypical Pulmonary Inflammatory Pseudotumor

作　　者：赖寿伟[1] 温毅强[1] 

机构地区：[1]广东医学院第三附属医院医学影像科,广东茂名525011

出　　处：《中国CT和MRI杂志》2014年第2期37-39,55,共4页Chinese Journal of CT and MRI

摘　　要：目的探讨不典型肺炎性假瘤的CT表现及其诊断价值。方法回顾性分析23例经手术或穿刺活检病理证实的肺炎性假瘤的CT表现,评价其诊断意义。23例行胸部CT平扫,其中18例同时行增强扫描。结果不典型肺炎性假瘤主要CT表现为软组织密度肿块或结节。病灶分布于肺的外围,3例伴邻近胸膜增厚、粘连。病灶呈圆形12例,椭圆形3例,不规则形8例。19例边缘清晰,4例边缘较模糊。边缘呈深分叶状4例,呈锯齿状7例,边缘毛糙9例,出现长毛刺6例。病灶密度较均匀19例,密度不匀匀4例,内见斑片状低密度区。增强扫描14例见轻至中度持续强化,4例显示周边部强化,4例可见强化的血管穿行于病灶内。结论肺炎性假瘤的CT表现具有多样性,综合分析各种征象有助于作出正确诊断.Objective To investigate the CT features of atypical pulmonary inflammatory pseudotumor. Methods Retrospectively studied CT findings of the 23 cases with pulmonary inflammatory pseudotumor, which were proved by pathology. All patients underwent CT plain scan and 18 of them underwent CT contrast enhanced scan. Results The main CT manifestation of pulmonary inflammatory pseudotumor was soft tissue mass or nodule. The lesions were located around the periphery of the lung in 23 cases. The base of the lesion were adhesive to pleura] with localized pleural thickening in 3 cases. The lesions usually presented multiple shape（round-shaped in 12 cases, oval-shaped in 3 cases, irregular-shaped in 8 cases）. 19 cases displayed sharply margin and margin was vague in 4 cases. The edge of lesion presented deep lobulation in 4 cases, serrated in 7 cases, coarse margin in 9 cases, long spiculation in 6 cases. The density of the lesions was homogeneous in 19 cases and inhomogeneous in 4 cases. The lesions were consistently enhanced in 14 cases. 4 cases displayed enhancement in the margin of lesion . Vessels crossed the lesion was found in 4 cases. Condlusion Pulmonary inflammatory pseudotumor exhibits diverse and untypical features on CT, but a comprehensive analysis of their characteristic features are helpful to improve the accuracy of diagnosis of it.

关 键 词：炎性假瘤 肺 体层摄影术 X线计算机 

分 类 号：R445.3[医药卫生—影像医学与核医学] R734.2[医药卫生—诊断学]