局灶性机化性肺炎的CT征象与病理对照分析  

Comparative analysis of CT signs and pathology of focal organizing pneumonia

作　　者：陈佳 王海亮 顾吾立 CHEN Jia;WANG Hailiang;GU Wuli(Department of Radiology,Zhejiang Chinese Medical University Affiliated Jiaxing TCM Hospital,Jiaxing 314000,China)

机构地区：[1]浙江省中医药大学附属嘉兴市中医医院放射科,浙江嘉兴314000

出　　处：《全科医学临床与教育》2023年第10期888-889,900,共3页Clinical Education of General Practice

基　　金：嘉兴市级课题(2021AD30135)。

摘　　要：目的分析局灶性机化性肺炎的CT征象,提高其影像学诊断的正确性。方法回顾性分析30例经手术或穿刺活检病理证实为局灶性机化性肺炎的CT表现。结果病例均为单发,右肺18例、左肺12例,其中11例位于胸膜下,呈宽基底与胸膜紧贴。病灶呈类圆形结节样9例、楔形13例、不规则形8例;边缘有长毛刺5例,边缘锯齿样改变6例。密度均匀7例、混杂密度23例。病灶边界清晰4例,边缘模糊17例,胸膜粘连增厚12例,胸膜凹陷3例,周围纤维条索影5例,支气管血管集束征4例,伴有少量胸腔积液4例。27例行增强检查,均匀明显强化5例,明显不均匀强化13例,环形强化2例,轻度强化5例,强化不明显2例。结论大部分的局灶性机化性肺炎CT征象具有一定特异性,经过综合分析可以明确诊断,但有些CT征象与肺癌等其他有所重叠,则需要借助病理检查。Objective To analyze the CT signs of focal organizing pneumonia and improve the accuracy of imaging di⁃agnosis.Methods The CT findings of 30 cases of focal organized pneumonia confirmed by operation or puncture biopsy were analyzed retrospectively.Results All the cases were solitary,including 18 cases of right lung and 12 cases of left lung,of which 11 cases were located under the pleura and the broad base was close to the pleura.The lesions were round nodular in 9 cases,wedge in 13 cases,irregular in 8 cases,long burr in 5 cases and serrated in 6 cases.The density was uniform in 7 cases and mixed density in 23 cases.The boundary of the focus was clear in 4 cases,blurred edge in 17 cas⁃es,pleural adhesion thickening in 12 cases,pleural depression in 3 cases,peripheral fibrous cord shadow in 5 cases,bronchovascular convergence sign in 4 cases,and a small amount of pleural effusion in 4 cases.In 27 cases,there were 5 cases of uniform obvious enhancement,13 cases of obvious inhomogeneous enhancement,2 cases of circular enhance⁃ment,5 cases of mild enhancement and 2 cases of inobvious enhancement.Conclusion Most of the CT signs of focal or⁃ganized pneumonia are specific and can be diagnosed by comprehensive analysis,but some CT signs overlap with others such as lung cancer,so pathological examination is needed.

关 键 词：局灶性机化性肺炎 体层摄影术 X线计算机 

分 类 号：R563.1[医药卫生—呼吸系统] R816.4[医药卫生—内科学]