多层螺旋CT在肺癌空洞与肺结核空洞诊断中的价值  

Value of Multislice Spiral CT in Diagnosis of Lung Cancer and Tuberculosis Cavities

作　　者：李建发 钱伟军 LI Jian-fa;QIAN Wei-jun(Department of Medical Imaging,Kaifeng Central Hospital,Kaifeng 475000,China)

机构地区：[1]开封市中心医院医学影像科,河南开封475000

出　　处：《实用临床医学（江西）》2023年第2期62-66,共5页Practical Clinical Medicine

基　　金：开封市科技发展计划项目(2103046)。

摘　　要：目的探讨多层螺旋CT(MSCT)在肺癌空洞与肺结核空洞诊断中的价值。方法对开封市中心医院2019年4月至2022年4月收治的经手术或穿刺活检、纤维支气管镜病理证实的30例肺癌空洞患者(肺癌组)和29例肺结核空洞患者(结核组)的临床及影像学资料进行回顾性分析,比较2组的MSCT表现,分析2组影像学特征的异同。结果肺癌组患者的年龄显著大于结核组(P<0.05),2组的性别及临床症状比较差异无统计学意义(P>0.05)。肺癌组病灶位置多位于中叶和下叶,结核组病灶位置多位于上叶;肺癌组病灶大于结核组;厚壁空洞多见于肺癌组,薄壁空洞多见于结核组;洞壁钙化多见于结核组;洞壁血管多见于肺癌组;空洞内部结构(分隔、血管穿行、壁结节)多见于肺癌组;空洞壁支气管闭塞、胸膜凹陷征多见于肺癌组,洞壁引流支气管、胸膜粘连、卫星灶多见于结核空洞组;肺癌组洞壁多见不均匀强化,结核组洞壁多见轻度环形强化;以上征象2组比较差异均有统计学意义(P<0.05)。2组患者空洞形态(外壁光整,内壁不光整;外壁不光整,内壁光整)比较差异无统计学意义(P>0.05)。结论肺癌空洞与肺结核空洞的MSCT征象存在一定差异,分析肺癌空洞与肺结核空洞影像学特征,可有效提高术前诊断的准确率。Objective To investigate the value of multislice spiral CT(MSCT)in the diagnosis of lung cancer and tuberculosis cavities.Methods The clinical and imaging data of 30 cases of lung cancer cavities and 29 cases of pulmonary tuberculosis cavities confirmed by surgery or puncture biopsy and fiberbronchoscopy who were treated in Kaifeng Central Hospital from April 2019 to April 2022 were retrospectively analyzed.The MSCT findings were compared between the two groups.Results The age of lung cancer cavity group was greater than that of tuberculosis cavity group(P<0.05).There were no significant differences in gender and clinical symptoms between the two groups(P>0.05).The lesions were mostly located in the middle and lower lobes in lung cancer cavity group,but in the upper lobe in tuberculosis cavity group.The size of lesions in lung cancer cavity group was larger than that in tuberculosis cavity group.Thick-and thin-walled cavities were more common in lung cancer cavity group and tuberculosis cavity group,respectively.Wall calcification and vessels were more common in tuberculosis cavity group and lung cancer cavity group,respectively.Internal structures(compartmentalization,vascularization and wall nodules)were more common in lung cancer cavity group.Bronchial occlusion and pleural indentation were more common in lung cancer cavity group,while drainage bronchus,pleural adhesion and satellite lesions were more common in tuberculous cavity group.Inhomogeneous enhancement and mild annular enhancement were more common in lung cancer cavity group and tuberculosis cavity group,respectively.The above signs were statistically different between the two groups(P<0.05).However,there were no significant differences in cavity morphology(smooth outer wall,unsmooth inner wall;unsmooth outer wall,smooth inner wall)between the two groups(P>0.05).Conclusion There are some differences in MSCT signs between lung cancer and tuberculosis cavities.Analysis of the imaging characteristics of lung cancer and tuberculosis cavities can effective

关 键 词：多层螺旋CT 肺癌空洞 肺结核空洞 影像学特征 

分 类 号：R521[医药卫生—内科学] R445.3[医药卫生—临床医学]