胸部疾病诊断中多种影像互补作用

目的：通过分析胸部较疑难的病例，总结胸部疾病诊断中多种影像互补作用。材料与方法：分析５０例经不同医院未确诊的较疑难病例。均有Ｘ线和ＣＴ材料，１７例有磁共振照片。常见病（肺炎、肺结核、肺癌）影像表现较特殊的２９例（５８％），余２１例（４２％）为少见病。这些病例作者均亲自做临床检查并全面分析影像材料。结果：胸片对于胸部较疑难病例正确诊断１１例（２２％）。ＣＴ诊断正确３２例（６４％）。磁共振有定性诊断价值者７例（占磁共振检查的４１％）。结论：（１）胸部正侧位片是胸部较疑难病例影像诊断的基础检查方法。（２）胸部ＣＴ是胸片常用而且主要的补充检查方法，在普通ＣＴ检查基础上有目的地采用增强扫描、高分辨ＣＴ扫描、螺旋ＣＴ扫描可提高ＣＴ诊断水平。（３）在ＣＴ基础上有目的地采用磁共振检查可发挥磁共振对于胸部疾病的诊断作用。

Supplementaryeffectsofvariousimagingmethodsindiagnosingthoracicdiseases

Purpose:Tosumupthesupplementaryefectsofvariousimagingmethodsindiag-nosingthoracicdiseasesthroughanalysingdificultandcomplicatedcases.Materialsandmethods:Fiftydificultandcomplicatedcasesfromvarioushospitalswereincluded,withoutadefinitediagno-sis.ChestradiogramandCThadbeenperformedinalpatients,MRIwasperformedin17ofthem.Therewere29cases(58%)ofcommondiseasesandraremanifestations,includingpneumonia,tu-berculosisandcarcinoma.Theremaining21cases(42%)hadrarediseases.Physicalexaminationofalthesepatientswasdonebytheauthorhimselfandthepatientsimageswereanalysedcomprehen-sively.Results:Corectdiagnosesofdificultandcomplicatedthoraciccasesweremadeonthebasisofchestradiogramin11cases(22%),and32cases(64%)byCT.MRimagingwashelpfulinestab-lishingfinaldiagnosisin7cases(accountingfor41%inthepatientswithMRimaging).Conclusion:Inthediagnosisofdificultandcomplicatedthoracicdiseases:(1)RoutineAPandlateralchestfilmswasthescreeningmethod.(2)ChestCTplayedanimportantroleinmanycircumstances.Ontheba-sisofroutineCTexamination,contrastCT,highresolutionCTandspiralCTcouldimproveCTdi-agnosticaccuracy.(3)MRIwasdoneafterCTexaminationandmightgiveacluetofinaldiagnosis.