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目的 提高对肺炎性假瘤的CT表现的认识,以便与其它球形病灶,特别是与肺癌病灶做出较正确的鉴别诊断。方法 作者收集近年来经手术和(或)纤维支气管镜活检病理证实的16例肺炎性假瘤,回顾性分析其CT表现。结果 主要的CT表现是:(1)病变呈椭圆形4例,三角形或不规则形4例,可见锯齿状或分叶7例;靠近胸膜的病灶,其两侧缘垂直于胸膜呈刀切样平直边缘5例。(2)病变中央密度高,边缘低,呈“晕圈样”改变7例;5例可见支气管充气征。(3)病灶周围,胸膜反应显著,广泛增厚10例;“卫星灶”6例;胸膜凹陷3例;病变周围血管纹理增多,增粗9例。结论 CT检查有助于明确炎性假瘤的诊断,“刀切样征”和“晕圈样”在诊断与鉴别诊断中有较高的价值。
Objective To improve the understanding of the CT findings of pneumococcal pseudotumor in order to make a more accurate differential diagnosis with other spherical lesions, especially lung lesions. Methods The authors collected 16 cases of pulmonary inflammatory pseudotumor confirmed by surgery and / or fiberoptic bronchoscopy biopsy in recent years and retrospectively analyzed the CT findings. Results The main CT findings were: (1) 4 cases of oval lesions, 4 cases of triangular or irregular shape, showing serrated or lobulated in 7 cases; close to the pleural lesions, both sides of the edge perpendicular to the pleura was knife-like Straight edge in 5 cases. (2) The central lesion density, low edge, was “halo-like” change in 7 cases; 5 cases of bronchial signs can be seen. (3) There was significant pleural reaction and extensive thickened in 10 cases, 6 cases of “satellite foci”, 3 cases of pleural indentation, and 9 cases of vascular thickening around the lesion. Conclusion CT examination can help to clarify the diagnosis of inflammatory pseudotumor, “knife-like sign” and “halo-like” in the diagnosis and differential diagnosis of high value.