周围型小肺癌的MSCT诊断及与局灶性机化性肺炎鉴别

发布时间：2018-05-02 17:30

  本文选题：肺肿瘤 + 肺炎　； 参考：《放射学实践》2015年07期

【摘要】：目的:探讨周围型小肺癌(SPLC)的MSCT征象及与局灶性机化性肺炎(FOP)的鉴别。方法:回顾性分析经病理证实、以孤立性肺结节为表现的58例SPLC和58例FOP的临床和MSCT资料,比较两者的MSCT征象及强化程度差异,并分析以强化程度为指标诊断SPLC的效能。结果:58例SPLC中圆形或类圆形42例,不规则形16例;边界清楚46例,边界模糊12例;深分叶33例,浅分叶7例;长毛刺8例,短毛刺37例;棘状突起19例,晕征8例,空泡6例,支气管充气征17例,坏死7例,胸膜凹陷征34例,胸膜增厚6例,血管集束征20例。58例FOP中圆形或类圆形20例,不规则形38例;边界清楚19例,边界模糊39例;深分叶11例,浅分叶8例;长毛刺32例,短毛刺9例;棘状突起11例,晕征21例,空泡11例,支气管充气征13例,坏死10例,胸膜凹陷11例,胸膜增厚42例,血管集束征18例。经卡方检验发现两组形态、边界、深分叶、长毛刺、短毛刺、晕征、胸膜凹陷征、胸膜增厚差异有统计学意义。58例SPLC中36例呈结节状均匀性强化,17例呈不均匀斑片状强化,5例轻度或无强化。FOP以不均匀或环形强化为主。两组强化程度差异具有统计学意义。以Ⅱ级、Ⅱ~Ⅲ级强化为诊断指标诊断SPLC的阳性似然比分别为4.67、1.67,诊断效能差。结论:综合分析SPLC与FOP的MSCT平扫及增强表现有助于鉴别诊断并减少误诊。
[Abstract]:Objective: to investigate the MSCT features of small peripheral lung cancer (SPLC) and its differential diagnosis with focal organized pneumonia (FOC). Methods: the clinical and MSCT data of 58 cases of SPLC and 58 cases of FOP confirmed by pathology were retrospectively analyzed. The differences of MSCT signs and enhancement degree between them were compared, and the effectiveness of diagnosis of SPLC with the degree of enhancement was analyzed. Results of 58 cases of SPLC, 42 cases were round or round, 16 cases irregular, 46 cases with clear boundary, 12 cases with blur, 33 cases with deep lobes, 7 cases with superficial lobes, 8 cases with long burr, 37 cases with short burr, 19 cases with spinous process, 8 cases with halo sign and 6 cases with vacuole. Bronchial inflation sign (n = 17), necrosis (n = 7), pleural indentation (n = 34), pleural thickening (n = 6), vascular cluster sign (n = 20) (n = 20), round or round (n = 20), irregular shape (n = 38), clear boundary (n = 19), blur (n = 39), deep lobulation (n = 11). Superficial lobes in 8 cases, long spurs in 32 cases, short spurs in 9 cases, spinous processes in 11 cases, halo sign in 21 cases, vacuoles in 11 cases, bronchial inflation sign in 13 cases, necrosis in 10 cases, pleural depression in 11 cases, pleural thickening in 42 cases, vascular bundle sign in 18 cases. By chi-square test, two groups of morphologies, boundary, deep lobes, long burr, short burr, halo sign, pleural depression sign, were found. There was significant difference in pleural thickening in 58 cases of SPLC. Among the 58 cases of SPLC, 36 cases showed nodular homogeneous enhancement and 17 cases showed uneven patch enhancement. 5 cases showed mild or no enhancement. There was significant difference in the degree of enhancement between the two groups. The positive likelihood ratios of grade 鈪，

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