肺内病变跨叶间裂征象的多层螺旋CT诊断价值

发布时间：2017-12-28 10:55

本文关键词：肺内病变跨叶间裂征象的多层螺旋CT诊断价值　出处：《中国医学影像学杂志》2017年08期 　论文类型：期刊论文

【摘要】：目的探讨肺内有跨叶间裂征象的病变的多层螺旋CT表现特点,结合病理结果,分析跨叶间裂征象对病变的诊断价值。资料与方法收集2015年10月-2016年10月49例经手术及病理证实或临床确诊的肺内有跨叶间裂征象病变患者的资料,回顾性分析其CT影像中病变的跨叶间裂征象及其他肺内表现。结果多发病变16例,单发跨叶间裂病变33例。多发病变中9例(56.3%)为感染性病变,包含结核杆菌、真菌、金黄色葡萄球菌及克雷伯杆菌感染,3例(18.7%)为腺癌,2例(12.5%)为转移瘤,1例(6.3%)为韦格纳肉芽肿,1例(6.3%)为抗中性粒细胞胞浆抗体相关性血管炎。单发病变中21例(63.6%)为恶性肿瘤,包括肺腺癌、鳞癌、淋巴瘤及转移瘤,6例(18.2%)为硬化性肺细胞瘤或错构瘤,边缘光滑,未见恶性征象;6例(18.2%)为炎性病变。结论肺内病变跨叶间裂生长的征象可见于恶性肿瘤、良性肿瘤及炎性病变,多发病变同时伴有跨叶征象时,以良性病变多见,亦可见于恶性肿瘤(转移瘤及肺癌肺内转移);单发病变同时伴有跨叶征象时,以恶性肿瘤多见,亦可见于机化性肺炎及良性肿瘤,单发的跨叶分布的机化性肺炎有时与恶性肿瘤鉴别困难,良性肿瘤特征明显时需考虑硬化性肺细胞瘤及错构瘤的可能性。
[Abstract]:Objective to investigate the features of multislice spiral CT in the lesions with interlobular fissure signs in the lung, and to analyze the diagnostic value of interlobular fissure signs to the lesions by pathological results. Materials and methods data of 49 cases of interlobar fissure lesions in lung confirmed by operation and pathology in October 2015 -2016 October were collected, and the signs of interlobar fissure and other pulmonary manifestations in CT images were retrospectively analyzed. Results there were 16 cases of multiple lesions and 33 cases of single interlobular fissure. Multiple lesions in 9 cases (56.3%) for infectious diseases, including tuberculosis, fungi, Staphylococcus aureus and Klebsiella pneumoniae infection, 3 cases (18.7%) adenocarcinoma, 2 cases (12.5%) metastasis, 1 cases (6.3%) as Wegener's granulomatosis, 1 cases (6.3%) for anti neutrophil cytoplasmic antibody associated vasculitis. 21 cases (63.6%) of solitary lesions were malignant tumors, including lung adenocarcinoma, squamous cell carcinoma, lymphoma and metastatic tumor. 6 cases (18.2%) were sclerosing pulmonary cell tumor or hamartoma, with smooth edges and no malignant signs. 6 cases (18.2%) were inflammatory lesions. Conclusion lung lesions cross fissural growth signs seen in malignant tumors, benign tumors and inflammatory lesions, multiple lesions accompanied by signs of cross leaf, benign lesions, may be found in malignant tumors (metastases of lung cancer and lung metastasis); single lesions accompanied by cross leaf signs, with malignant tumors see, it can also be seen in organizing pneumonia and benign tumor, organizing pneumonia across the distribution of single leaf and sometimes difficult to distinguish malignant tumors, consider the possibility of sclerosing lung cell tumor and hamartoma need obvious characteristics of the benign tumor.
【作者单位】：首都医科大学大兴教学医院放射科;解放军总医院放射科;
【分类号】：R730.44;R734.2
【正文快照】： 通讯作者聂永康Department of Radiology,Chinese PLAGeneral Hospital,Beijing 100853,ChinaAddress Correspondence to:NIE YongkangE-mail:nieyongkang@sina.comR563;R445.3修回日期:2017-04-27中国医学影像学杂志2017年第25卷第8期:583-586Chinese Journal of Medical Ima

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