局灶性机化性肺炎与肺癌的影像学及临床特征分析

发布时间：2018-02-14 18:05

  本文关键词： 肺癌 机化性肺炎 CT(计算机断层扫描) 毛刺　出处：《延边大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:探讨机化性肺炎(organizing pneumonia,OP)与肺癌的影像学特征,提高CT对机化性肺炎和肺癌的鉴别诊断价值。资料和方法:回顾性研究8例已经进行病理检查证实的OP患者,随机选择31例肺癌患者作为对照组。比较两组临床特征、CT表现及病变强化模式。本次研究已通过延边大学附属医院伦理委员会批准。患者主要临床表现为咳嗽、咳痰、咯血、胸痛、气促、发热等,本研究主要集中在CT表现的对比分析。通过两独立样本t检验和卡方(χ2)检验比较两组的结果。P0.05表示差异具有统计学意义。以下为观察的CT特征:位置、分布、大小、支气管、毛刺、腔洞、坏死,增强、钙化、磨玻璃影、支气管血管影、支气管扩张、结节影、淋巴结。结果:肺癌组共31例,其中男性18例,女性13例。年龄41～82岁,平均年龄(63.42±10.69)岁。左肺10例,占32.3%,其中左肺上叶5例,左肺下叶3例,左肺门2例。右肺21例,占67.7%,右肺上叶10例,右肺中叶3例,右肺下叶5例,右肺门3例。病变主要分布在中央21例,占67.7%,周围10例,占32.3%。病灶的大小范围1.7～11cm,平均大小为4.98±2.12cm。在CT的肿块病变有毛刺11例,占35.5%,异常支气管24例,占77.4%(1例支气管扩张、10例支气管狭窄、13例阻塞支气管),空洞8例,占25.8%,坏死4例,占12.9%,动脉期净增强CT值28.4HU,静脉期净增强CT值25.1HU。局部周边的CT改变为磨玻璃影16例,占51.6%,支气管血管周围磨玻璃影18例,占58.1%,支气管扩张3例,占9.7%,结节影17例,占54.8%,淋巴肿大24例,占77.4%。机化性肺炎组共8例,其中男性7例,女性1例。年龄35～75岁,平均年龄(51.38±12.83)岁。左肺2例,占25%,均位于左肺下叶。右肺6例,占75%,其中右肺上叶2例,右肺中叶2例,右肺下叶2例。全部病变发生于周围8例,占100%。病灶的大小范围为1.3～6cm,平均大小3.33土 1.64cm。在CT的肿块病变有毛刺0例,异常支气管2例,占25%(1例支气管狭窄、1例阻塞支气管),空洞3例,占37.5%,坏死1例,占12.5%,动脉期净增强CT值23.2HU,静脉期动脉净增强CT值36HU。局部周边的CT改变为磨玻璃影1例,占12.5%,支气管扩张1例,占12.5%,淋巴肿大2例,占25%。通过临床资料和CT表现在两组病例中进行比较分析,我们发现肺癌组平均年龄(63.42±10.69)岁,明显高于机化性肺炎组(51.38 士 12.83)岁,且有统计学意义(P0.05)。咳嗽、毛刺、磨玻璃影、支气管血管周围磨玻璃影、结节影和淋巴结在肺癌组明显高于机化性肺炎组,差异有统计学意义(P0.05)。同时机化性肺炎组呼吸困难、胸痛及静脉期造影增强高于肺癌组,差异有统计学意义(P0.05)。其他CT表现均无统计学意义(P0.05)。结论:对局灶性机化性肺炎及肺癌的CT表现、分布及临床特点的详细分析有助于分辩两者的鉴别诊断
[Abstract]:Objective: to investigate the imaging features of organizing pneumonia-opp and lung cancer, and to improve the value of CT in differential diagnosis of organic pneumonia and lung cancer. Data and methods: a retrospective study of 8 patients with op confirmed by pathological examination was made. Thirty-one patients with lung cancer were randomly selected as the control group. The clinical features of the two groups were compared with CT findings and enhancement models. This study was approved by the Ethics Committee of the affiliated Hospital of Yanbian University. The main clinical manifestations of the patients were cough, expectoration and hemoptysis. Chest pain, shortness of breath, fever and so on. This study mainly focuses on the comparative analysis of CT findings. The results of the two groups were compared by t-test of two independent samples and chi-square (蠂 ~ 2) test. Distribution, size, bronchus, burr, cavity, necrosis, enhancement, calcification, vitreous shadow, bronchovascular shadow, bronchiectasis, nodular shadow, lymph node. 13 cases were female. The average age was 63.42 卤10.69 years old. There were 10 cases of left lung, including 5 cases of left upper lobe, 3 cases of left lower lobe, 2 cases of left hilum, 21 cases of right lung (67.7%), 10 cases of upper lobe of right lung, 3 cases of middle lobe of right lung and 5 cases of lower lobe of right lung. Right hilum was found in 3 cases. The lesions were mainly distributed in the center of 21 cases (67.7%), around 10 cases (32.3cm). The size of the lesions was 1.711cm, the average size was 4.98 卤2.12cm.There were 11 cases of burr in CT, accounting for 35.5cm, and 24 cases of abnormal bronchus. One case of bronchiectasis, 10 cases of bronchiectasis, 10 cases of bronchial stenosis, 13 cases of obstruction of bronchus, 8 cases of cavity (25.8%), 4 cases of necrosis (12.9%), 28.4 HUU in arterial phase and 25.1HU in venous phase. The local peripheral CT changes were glassy shadow in 16 cases. There were 18 cases of bronchiectasis (58.1%), 3 cases of bronchiectasis (9.7%), 17 cases of nodular shadow (54.8%), 24 cases of lymphoid enlargement (77.4%). The mean age was 51.38 卤12.83 years old. There were 2 cases of left lung, 25 cases of right lung, and 6 cases of right lung, including 2 cases of upper lobe of right lung, 2 cases of middle lobe of right lung and 2 cases of lower lobe of right lung. The size of the lesion was 1.3 ~ 6 cm, with an average size of 3.33 卤1.64 cm. In CT, there were burrs in 0 cases, abnormal bronchus in 2 cases, and bronchial stenosis in 1 case (1 case), cavity in 3 cases (37.5%) and necrosis in 1 case. The CT value was 23.2HUU in arterial phase and 36HU in venous phase. The local peripheral CT changes were glassy shadow in 1 case (12.5%), bronchiectasis in 1 case (12.5%), lymphomegaly in 2 cases, bronchiectasis in 1 case, and lymphomegaly in 2 cases. The average age of lung cancer group was 63.42 卤10.69 years old, which was significantly higher than that of organic pneumonia group (51.38 卤12.83) years. The peribronchovascular opacity, nodular shadow and lymph nodes were significantly higher in lung cancer group than in lung cancer group (P 0.05). At the same time, the patients with organized pneumonia had difficulty breathing, chest pain and venography were higher than those in lung cancer group. The difference was statistically significant (P 0.05). There was no significant difference in other CT findings. Conclusion: the detailed analysis of CT manifestations, distribution and clinical characteristics of focal organized pneumonia and lung cancer is helpful to distinguish the differential diagnosis between the two.
【学位授予单位】：延边大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R734.2;R730.44;R563.1
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本文编号：1511288