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作 者:王丽丽 李天成 刘博乐 洪俊杰 徐妮娜 郑祥武[1] WANG Lili;LI Tiancheng;LIU Bole;HONG Junjie;XU Nina;ZHENG Xiangwu(Department of Radiology,the First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325000,China)
机构地区:[1]温州医科大学附属第一临床医院放射科,浙江温州325000
出 处:《中国医学影像学杂志》2020年第3期205-209,共5页Chinese Journal of Medical Imaging
基 金:浙江省自然科学基金项目(LY17H180009)。
摘 要:目的探讨隐源性机化性肺炎(COP)的影像学及临床特征,提高对本病的认知与诊断水平。资料与方法回顾性分析133例COP患者的基本信息、实验室检查资料和CT表现,根据病灶CT形态学特征进行分类。结果 133例COP患者中,实变型71例,其中伴灶周磨玻璃密度影47例;实性结节/肿块型54例,单发结节或肿块型29例,其中伴胸膜尾征5例、边缘平直征23例、晕征11例;多发结节或肿块型25例,其中伴卫星灶9例,结节或肿块型CT首诊为肺癌达44.4%;磨玻璃型8例,其中伴碎路石征3例、反晕征1例。实变型患者白细胞计数、C反应蛋白、血细胞沉降率、纤维蛋白原及D-二聚体异常升高率均高于结节/肿块型,差异有统计学意义(P<0.05)。结论 COP的胸部CT表现复杂多样,其中实变型最常见,结合临床资料可提示炎性病变;结节/肿块型病灶易误诊为肺癌,胸膜尾征、平直征、晕征具有一定的特征性,有助于鉴别诊断。Purpose To investigate the imaging and clinical features of cryptogenic organizing pneumonia(COP), and to improve the cognitive and diagnostic levels of the disease. Materials and Methods Clinical data, laboratory data and CT findings of 133 COP patients were retrospectively collected, and classified according to the CT morphological characteristics of the lesions. Results Among the 133 patients with COP, 71 were in the consolidation form, of which 47 were in the peripheral ground-glass opacity. Among 54 consolidated nodule and mass type, there were 29 single nodules or mass types, including 5 cases combined pleural tail sign, 23 cases of edge straight sign and 11 cases of halo sign. Among 25 multiple nodules or mass types, there were 9 cases of satellite foci. The misdiagnosis rate of nodular or mass type CT as lung cancer was 44.4%. There were 8 ground-glass types combining 3 cases of gravel-road signs and 1 case of reversed halo sign. The abnormally elevated rates of leukocyte count, C-reactive protein, blood cell sedimentation rate, fibrinogen, and D-dimer in patients with consolidation were higher than those in nodule/bulk type, and the differences were statistically significant(P<0.05). Conclusion Chest CT findings of COP are complicated and diversified, and consolidated types are most common. Inflammatory lesions can be indicated combined with clinical information. Nodule and mass type lesions can be easily misdiagnosed as lung cancer. The pleural tail sign, edge straight sign and halo sign are of certain characteristics, which are favorable for differential diagnosis.
关 键 词:隐源性机化性肺炎 体层摄影术 螺旋计算机 诊断 鉴别
分 类 号:R445.3[医药卫生—影像医学与核医学] R563.1[医药卫生—诊断学]
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