论文部分内容阅读
目的 探讨肺孤立结节增强CT表现特点、周围肺血管异常改变与病理的关系。材料与方法 46例不同病理性质的孤立肺结节 (直径 10～ 3 0mm)行螺旋CT增强扫描 ,研究结节强化特点及其周围肺血管改变。全部病例均经手术及病理证实。结果 46例肺孤立性结节强化者 42例 ,全部肺癌和炎性结节均显著强化 ,其中结节呈均匀和不均匀强化各 16例 (肺癌 19例 ,炎性假瘤 8例 ,错构瘤 1例 ,结核瘤 4例 ) ;周围强化 10例 ,其中肺癌 5例 ( 3例呈环状强化 ) ,炎性结节 5例 ( 3例肺脓肿呈环状 )。未强化者 4例 (肺结核 3例 ,错构瘤 1例 )。表现结节内血管征 9例 ,其中肺癌 7例 ,炎性假瘤 2例。局部充血征 6例 ,均为炎性结节 ;淤血征 8例 ,肺血管纠集征 7例 ,均为肺癌。结论 肺癌、炎性结节较结核瘤显著强化 ,结节强化表现与病理无明显相关性 (P >0 .0 5 ) ;结节内血管征、邻近肺野局部充血、淤血及血管纠集征则对鉴别诊断炎性结节与肺癌具有重要意义。
Objective To investigate the features of enhanced pulmonary CT in solitary pulmonary nodules and the relationship between pulmonary vascular abnormalities and pathology. Materials and Methods 46 cases of pulmonary nodules with different pathological features (diameter of 10 ~ 30 mm) were scanned with spiral CT to study the features of nodular enhancement and pulmonary vascular changes. All cases were confirmed by surgery and pathology. Results Forty-six cases of pulmonary nodular enhancement were performed in 42 cases. All of the lung cancer and inflammatory nodules were significantly enhanced. Among them, 16 cases were uniformly and heterogeneously nodular (19 cases of lung cancer, 8 cases of inflammatory pseudotumor, 1 case of tumor and 4 cases of tuberculoma). There were 10 cases of peripheral enhancement, including 5 cases of lung cancer (3 cases showed annular enhancement) and 5 cases of inflammatory nodules (3 cases of lung abscess were annular). 4 cases did not strengthen (tuberculosis in 3 cases, hamartoma in 1 case). Nodular manifestations of blood vessels in 9 cases, including 7 cases of lung cancer, inflammatory pseudotumor in 2 cases. Local congestion in 6 cases, all inflammatory nodules; congestion in 8 cases, 7 cases of pulmonary vascular collection signs, are lung cancer. Conclusions Lung cancer and inflammatory nodules are significantly stronger than tuberculoma, and no significant correlation between nodular enhancement and pathology (P> 0.05). The signs of nodules, local hyperemia in adjacent lung fields, The differential diagnosis of inflammatory nodules and lung cancer is of great significance.