肺部细菌感染的MSCT特殊表现及其误诊分析  

Study The Special Imaging Manifestations of Pulmonary Bacterial Infection and MisdiagnosisAnalysis with MSCT

作　　者：王刚[1] 袁焕初[1] 谢远萍 邹玉坚[1] 梁满球[1] Wang Gang;Yuan Huanchu;Xie Yuanping;Zou Yujian;Liang Manqiu(Radiology department of Dong Guan People’s Hospital,Dongguan,Guangdong 523059)

机构地区：[1]东莞市人民医院放射科

出　　处：《现代医用影像学》2019年第8期1719-1721,共3页Modern Medical Imageology

摘　　要：目的:分析肺部细菌感染的MSCT特殊影像表现,旨在提高对肺部细菌感染的MSCT征像的全面认识,降低误诊率。材料与方法:收集经病理活检或临床证实、首次诊断误诊的肺细菌感染33例,均行MSCT平扫及增强检查,CT扫描常规层厚8mm,薄层扫描层厚1.5mm。根据病变形态进行分型,回顾性分析每例病变的影像学特征,包括形态、边缘、密度、与支气管及血管的关系、邻近胸膜的改变、强化特点,并总结误诊的原因。结果:33例患者,误诊肿瘤11例,结核8例,真菌12例,血管炎2例;其中I型8例,II型15例,III型10例。表现为支气管狭窄或中断5例,其余28例支气管未见明显异常改变;病变内及周围血管分布形态正常28例,推压移位5例,均未见血管破坏征象;密度均匀28例,增强扫描均匀强化22例。结论:MSCT可以较好的显示肺部细菌感染的特殊影像学表现,能够有效提高肺部细菌感染的诊断准确率,较少误诊。Objective:To study the special imaging of MSCT in pulmonary bacterial infection,and improve the overall understanding of MSCT features in bacterial pulmonary infection and reduce the rate of misdiagnosis.Materials and Methods:33 misdiagnosed cases of pulmonary bacterial infections with MSCT plain and enhanced scan which were confirmed by pathological biopsy or clinical treatment.Thickness of CT exam was 8 mm with routine scanning and 1.5 mm with thinner scanning.All cases were classified according to the lesion form.The imaging features were analyzed retrospectively,including morphology,margin,density,relation with bronchial and vascular,changes of adjacent pleura,and enhancement characteristics.The reasons for misdiagnosis were summarized.Result:Of all 33 cases,11 cases were misdiagnosed as tumor,8 cases were misdiagnosed as tuberculosis,12 cases were misdiagnosed as pulmonary mycosis,and 2 cases were misdiagnosed as vasculitis.33 cases include 8 cases of type I,15 cases of type II,and 10 cases of type III.5 cases displayed bronchial stenosis or interruption,while the other 28 cases showed no obvious abnormal changes in bronchus.There were 28 cases with normal vascular distribution and 5 cases with vessel displacement,and no signs of vascular destruction.The density of lesions was uniform in 28 cases and the homogeneous enhancement in 22 cases were found.Conclusion:With MSCT exam,which can better display the imaging characteristics of pulmonary bacterial infection,effectively improve the diagnostic accuracy and reduce misdiagnosis rate.

关 键 词：肺 感染 细菌 螺旋CT 误诊 

分 类 号：R73[医药卫生—肿瘤]