肺泡型包虫病的CT表现及其与肺转移瘤鉴别诊断的研究

发布时间：2018-03-03 16:03

本文选题：泡型包虫病　切入点：转移瘤　出处：《青海大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:探讨肺泡型包虫病的CT表现、特性征象分析及其与肺转移瘤的鉴别诊断。材料和方法:回顾性分析我院经临床、实验室检查及病理证实的肺泡型包虫病患者50例,肺转移瘤患者50例,各行胸部CT扫描及部分患者胸部CT增强扫描。结合各患者原发病史及CT表现,分析其征象:如病灶位置、大小、病灶内部及其周围各种CT征象如有无分叶征、毛刺征、晕征、钙化、空泡、空洞(有无液平、壁结节或洞内结节、洞壁厚度)及强化程度等。所得数据分别采用t检验及χ2检验进行比较分析。结果:50例肺泡型包虫患者的原发灶均起于肝脏,肺内多发病灶43例;50例肺转移瘤患者原发病灶位于肺脏16例,肝脏23例,乳腺6例,骨组织2例,甲状腺1例,前列腺2例,肺内多发病灶46例。50例转移性肺AE患者,病灶主要以双肺外带和肺底分布为主,21例患者胸膜增厚;39例出现钙化;15例出现空洞,其中10例呈偏心性,空洞边缘出现钙化12例,1例形成巨大厚壁不规则空洞并洞壁钙化,内见少量气液平面;16例显示结节内小空泡;10例患者行胸部CT强化,其中9例未见强化,1例仅部分病灶轻微强化。50例肺转移瘤患者,病灶主要以双肺外带为主,5例引起胸膜局限性增厚;4例出现钙化;2例空洞呈偏心性;5例多发小空泡;23例患者行胸部CT强化,15例患者无-轻度强化,7例患者中-重度强化。肺泡型包虫与肺转移瘤在年龄、最大病灶大小、钙化、空泡、空洞、洞内结节或壁结节及胸膜有无增厚具有统计学差异(p0.05),两组间其他各征象差异不具有统计学意义。结论:肺泡型包虫病具有强地域性,好发于牧区,青中年多见,“靶征”、“空泡征”及特征性空洞具有诊断意义;肺转移瘤具有明确恶性肿瘤占位史,好发于中老年,大多数表现为实性结节。结合临床、病史及肺部CT表现,对诊断及鉴别诊断这两种病至关重要。
[Abstract]:Objective: to investigate the CT features, characteristic features and differential diagnosis of alveolar hydatidosis and pulmonary metastases. Materials and methods: 50 cases of alveolar hydatid disease confirmed by clinical, laboratory and pathological examination in our hospital were retrospectively analyzed. Fifty patients with pulmonary metastases were examined with chest CT scan and CT enhanced CT scan of part of the patients. Combined with the history of primary disease and CT manifestations of each patient, the signs were analyzed, such as the location and size of the lesion, the size of the lesion, the location of the lesion, the size of the lesion, Various CT signs such as lobulation, burr sign, halo sign, calcification, vacuole, cavitation (with or without flattened fluid, wall nodule or cavity nodule) were found in and around the lesion. The data were analyzed by t test and 蠂 2 test respectively. Results the primary foci of 50 patients with alveolar hydatid originated from liver. 43 patients with multiple pulmonary lesions and 50 patients with pulmonary metastases were located in 16 cases of lung, 23 cases of liver, 6 cases of mammary gland, 2 cases of bone tissue, 1 case of thyroid gland, 2 cases of prostate, 46 cases of multiple lesions in lung and 50 cases of metastatic pulmonary AE. The lesions were mainly located in the extrapulmonary zone and the pulmonary floor in 21 patients with pleural thickening in 39 cases and calcification in 15 cases, in which 10 cases were eccentric, 12 cases had calcification at the margin of the cavity and 1 case had formed a huge thick wall irregular cavity and calcification of the wall of the cavity. A small amount of gas-liquid plane was found in 16 cases, 10 patients with small vacuoles in the nodules were performed chest CT enhancement, of which 9 cases did not show enhancement in 1 case, and only a few lesions were slightly enhanced in 1 case. 50 cases of pulmonary metastases were found. The focus was mainly bilateral extrapulmonary zone in 5 cases with localized thickening of pleura, 4 cases with calcification, 2 cases with eccentric cavity, 5 cases with multiple cavitation, 23 cases with chest CT enhancement, 15 cases with non-mild enhancement and 7 cases with moderate and severe lesions. Alveolar hydatid and pulmonary metastases at age, The largest lesion size, calcification, vacuole, cavity, nodule or wall nodule in the cavity and pleural thickening had statistical difference (p0.05). There was no significant difference in other signs between the two groups. Conclusion: alveolar hydatidosis has strong regional character. In pastoral areas, youth and middle age are more common, "target sign", "vacuolar sign" and characteristic cavity have diagnostic significance, pulmonary metastases have a clear history of malignant tumors, tend to occur in middle and old age, most of them are solid nodules. The history and CT findings of lung are very important for the diagnosis and differential diagnosis of these two diseases.
【学位授予单位】：青海大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R532.32;R734.2;R730.44

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