孤立结节型肺隐球菌病与实性肺腺癌的CT鉴别诊断  

CT Differential Diagnosis of Solitary Nodular Pulmonary Cryptococcosis and Solid Lung Adenocarcinoma

作　　者：陈倩 胡恩德 刘凯丽 肖慧 CHEN Qian;HU En-de;LIU Kai-li;XIAO Hui(Fujian University of Traditional Chinese Medicine,Fuzhou 350122,Fujian Province,China;Department of Critical Care Medicine,The First Affiliated Hospital of Fujian Medical University,Fuzhou 350005,Fujian Province,China;Department of Radiodiagnosis,Fuzong Clinical School of Fujian Medical University,Fuzhou 350025,Fujian Province,China;Department of Radiodiagnosis,The 900th Hospital of the Joint Support Force,Fuzhou 350025,Fujian Province,China)

机构地区：[1]福建中医药大学,福建福州350122 [2]福建医科大学附属第一医院重症医学科,福建福州350005 [3]福建医科大学福总临床医学院(放射诊断科),福建福州350025 [4]联勤保障部队第九〇〇医院放射诊断科,福建福州350025

出　　处：《中国CT和MRI杂志》2023年第1期53-55,共3页Chinese Journal of CT and MRI

摘　　要：目的 分析免疫正常者孤立结节型肺隐球菌病与实性肺腺癌的CT影像表现,寻找鉴别诊断有意义征象,以提高确诊率。方法 回顾性收集26例免疫正常者孤立结节型肺隐球菌病及29例实性肺腺癌患者的CT及临床资料,重点分析比较两组病变病灶分布、大小、分叶征、毛刺征、支气管充气征、空泡征、晕征、血管集束征、胸膜凹陷征、与胸膜接触面以及CT增强情况。结果 孤立结节型肺隐球菌病平均发病年龄小于实性肺腺癌,且病灶较小,晕征(53.85%)及支气管充气征(65.38%)多见;实性肺腺癌患者分叶征(96.55%)、毛刺征(93.10%)、血管集数征(96.55%)及胸膜凹陷征(93.10%)比例高于孤立型肺隐球菌病患者,两组比较均有显著性差异(P<0.05)。结论 晕征及支气管充气征在孤立结节型肺隐球菌病具有特征性,与胸膜接触面宽基底为较为特征的CT表现。Objective To analyze the CT findings of isolated nodular pulmonary cryptococcosis and solid pulmonary adenocarcinoma in normal immunized patients, and to search for significant signs in differential diagnosis, so as to improve the diagnosis rate. Methods Retrospective analysis of CT and clinical data of 26 patients with isolated nodular pulmonary cryptococcosis in patients with normal immunity and 29 patients with solid pulmonary adenocarcinoma.The distribution, size, lobulation sign, burr sign, bronchial inflation sign, vacuolar sign, halo sign, vascular aggregation sign, pleural depression sign, pleural contact surface and CT enhancement of the two groups were analyzed and compared. Results The average age of onset of solitary nodular pulmonary cryptococcosis was less than that of solid lung adenocarcinoma, and the lesions were smaller. Halo signs(53.85%) and bronchial inflation signs(65.38%) were more common. The proportions of lobulation sign(96.55%), burr sign(93.10%), vascular aggregation sign(96.55%) and pleural depression sign(93.10%) in solid lung adenocarcinoma patients were higher than those in isolated pulmonary cryptococcus patients, and there were significant differences between the two groups(P<0.05). Conclusion Halo signs and bronchial inflation signs are characteristic in isolated nodular pulmonary cryptococcosis, and the broad base of contact surface with pleura is the characteristic CT findings.

关 键 词：免疫正常 肺隐球菌病 肺腺癌 CT 

分 类 号：R519.4[医药卫生—内科学] R445.3[医药卫生—临床医学]