肺炎性假瘤、周围型肺癌的CT影像学特征及其鉴别诊断  

CT Imaging Features and Differential Diagnosis of Pulmonary Inflammatory Pseudotumor and Peripheral Lung Cancer

作　　者：吴春燕 何川东 陈正国 赵丹 周莉 赵玲 WU Chun-yan;HE Chuan-dong;CHEN Zheng-guo;ZHAO Dan;ZHOU Li;ZHAO Ling(Department of Radiology,Mianyang Central Hospital,School of Medicine,University of Electronic Science and Technology of China,Mianyang 621000,Sichuan Province,China)

机构地区：[1]电子科技大学医学院附属绵阳医院·绵阳市中心医院放射科,四川绵阳621000

出　　处：《中国CT和MRI杂志》2022年第4期51-52,68,共3页Chinese Journal of CT and MRI

基　　金：四川省科技支撑项目(2015SZ0159)。

摘　　要：目的探讨肺炎性假瘤、周围型肺癌的CT影像学特征及其鉴别诊断。方法回顾性分析2015年7月至2020年3月期间本院所收治的98例炎性假瘤及周围型肺癌患者的临床资料,比较肺炎性假瘤与周围型肺癌患者的CT征象,并进行分析。结果周围性肺癌患者在“结节”、“分叶”征、胸膜“凹陷”征等征象较多于肺炎性假瘤者,“桃尖”征及延时期持续强化情况发生率较低于肺炎性假瘤者(P<0.05);在“空洞”、“边界”、“钙化”等征象上比较(P>0.05),两者在“空洞”、“边界”、“钙化”方面比较未见差异(P>0.05)。肺炎性假瘤均为单发性病灶,多呈类圆形或不规则形病灶,部分边缘稍模糊,可见磨玻璃影,局部胸膜增厚,“分叶”征、“空洞”征及肿大淋巴结少见,增强扫描延时期病灶呈持续性强化;周围型肺癌多呈类圆形或不规则形,直径约为2~3cm,病灶边缘可见“分叶”征,毛刺细短密集,伴有少许钙化,可见胸膜“凹陷”征及血管“集束”征,增强扫描中延时期持续强化不明显。结论CT可作为鉴别肺炎性假瘤与周围型肺癌的可靠检查手段,为临床诊断提供依据。Objective To explore the CT imaging features and differential diagnosis of pulmonary inflammatory pseudotumor and peripheral lung cancer.Methods The clinical data of 98 patients with inflammatory pseudotumor or peripheral lung cancer admitted to our hospital from July 2017 to September 2019 were retrospectively analyzed,and the CT signs of pulmonary inflammatory pseudotumor and peripheral lung cancer of patients were compared and analyzed.Results Compared with patients with pneumonia and pseudotumor,patients with peripheral lung cancer had more signs of"nodules","lobular signs","pleural depression sign"and other signs,and the incidence of"peach tip signs"and continuous enhancement in the delayed period was lower(P<0.05).There was no statistical difference in the signs such as“voids”,“boundaries”,and"calcifications"(P>0.05).And there was no difference in“voids”,“boundaries”,and"calcifications"(P>0.05).Pneumonic pseudotumors were single lesions,mostly round or irregular,part of the edge was slightly blurred,ground-glass opacity was visible,local pleural thickening,lobulation sign,cavity sign and enlarged lymph nodes are rare.The enhanced scan showed a continuous enhancement of the lesion in delay period.Peripheral lung cancer was mostly round or irregular.The diameter was about 2~3 cm,and the lobation sign can be seen at the edge of the lesion.The burrs were short and dense,accompanied by a little calcification.Pleural depression sign and vascular bundle sign were seen,and continued enhancement in delay period of the enhanced scan was not obvious.Conclusion CT can be used as a reliable test to distinguish pulmonary inflammatory pseudotumor from peripheral lung cancer,and provide a basis for clinical diagnosis.

关 键 词：肺炎性假瘤 周围型肺癌 影像学特征 

分 类 号：R563.1[医药卫生—呼吸系统] R734.2[医药卫生—内科学]