论文部分内容阅读
目的研究局灶肺炎ＣＴ影像的鉴别诊断价值。方法局灶肺炎２５例，均诊断或疑诊为周围型肺癌。病人年龄均在４０岁以上，其中５０～８０岁２１例，占８４％；无临床症状１３例，占５２％；痰中带血５例，占２０％。ＣＴ设备档次不同，均未做增强。结果ＣＴ表现有３种：（１）不规则结节，磨玻璃样密度，其中见少数点状高密度灶；（２）不规则形状结节，边缘较清楚，边缘毛刺，密度均匀；（３）形状规则结节，边缘清楚，密度均匀。这３种表现以第３种多见。好发生于两肺下叶背段或后基底段１５例，占６０％。除３例手术外，２２例均经抗炎治疗，２～３周吸收１８例，占２２例中的８２％。结论临床和影像有时鉴别局灶肺炎和周围型肺癌较困难。在ＣＴ上不规则形状结节且边缘有毛刺，而在胸片上边缘毛刺不明确，证明胸片有助于诊断。在相同层面上观察肺窗和纵隔窗病灶大小的变化，若纵隔窗较肺窗明显缩小多见于肺炎，肺泡癌也可有这种变化，抗炎治疗观察２～３周对于鉴别诊断有价值
Objective To study the differential diagnosis of focal pneumonia in CT images. Methods 25 cases of focal pneumonia were diagnosed or suspected peripheral lung cancer. Patients were over 40 years of age, of which 21 cases of 50 to 80 years old, accounting for 84%; no clinical symptoms in 13 cases, accounting for 52%; sputum blood in 5 cases, accounting for 20%. CT equipment, different grades, no enhancement. Results CT showed three kinds: (1) irregular nodules, ground glass-like density, of which a small number of spot-shaped high-density lesions; (2) irregular shape nodules, the edge of the more clear edge burr, uniform density; Regular shape nodules, clear edges, uniform density. These three kinds of performance in the first three more common. Occurred in the lower lung or lower posterior segment of the basal segment in 15 cases, accounting for 60%. In addition to the three cases of surgery, 22 cases were anti-inflammatory treatment, 2 to 3 weeks to absorb 18 cases, accounting for 82% of 22 cases. Conclusion Clinical and imaging sometimes distinguish focal pneumonia and peripheral lung cancer more difficult. Irregular shape of nodules on CT and the edge of the burr, and the edge of the chest on the edge of the burr is not clear, to prove that the chest will help diagnose. In the same level of observation of lung window and mediastinal window lesions size changes, if the mediastinal window was significantly smaller than the lung window more common in pneumonia, alveolar cancer can also have this change, anti-inflammatory treatment of observation 2 to 3 weeks for the differential diagnosis of valuable