周围型肺癌、炎性假瘤CT征象及鉴别诊断分析

目的探讨周围型肺癌、炎性假瘤CT征象及鉴别诊断。方法收集2014年1月至2019年1月于我院就诊治疗的58例周围型肺癌和74例炎性假瘤患者的临床及影像学资料,分析比较其CT征象的差异。结果分叶征、短毛刺、胸膜凹陷征象周围型肺癌发生率显著高于炎性假瘤,而长毛刺、切线征和尖角征周围型肺癌发生率显著低于炎性假瘤(P<0.05)。周围型肺癌主动脉期强化明显,于120s左右达到CT值高峰,42例(72.41%)侵犯或包绕邻近血管;炎性假瘤肺动脉期病灶逐渐强化,于90sCT值达到最高峰,52例(70.27%)对邻近血管产生推移。结论周围型肺癌与炎性假瘤在多项CT征象中存在较大差异,不同病灶其CT增强时相血流灌注及与血管关系存在一定特征性,故CT平扫及多期增强扫描检查有利于其鉴别诊断。

CT Features and Differential Diagnosis of Peripheral Lung Cancer and Inflammatory Pseudotumor

Objective To explore the CT signs and differential diagnosis of peripheral lung cancer and inflammatory pseudotumor.Methods The clinical and imaging data of 58 patients with peripheral lung cancer and 74 patients with inflammatory pseudotumor who were treated in our hospital from January 2014 to January 2019 were collected.The CT signs of the two diseases were recorded and compared.Results The foliation sign,short burr,pleural depression sign of peripheral lung cancer were significantly higher than that of inflammatory pseudotumor,while that of long burr,tangent sign,and sharp Angle sign were significantly lower than that of inflammatory pseudotumor(P<0.05).The aortic stage of peripheral lung cancer was enhanced significantly,reaching the peak CT value at about 120s,and 42 cases(72.41%)of lesions invaded or surrounded the adjacent vessels.The pulmonary artery lesion of inflammatory pseudotumor was gradually strengthened,and the CT value reached the peak in 90s,52 cases(70.27%)of lesions pushed on adjacent blood vessels.Conclusion Peripheral lung cancer and inflammatory pseudotumor have great differences in multiple CT signs.The blood perfusion of different lesions during CT enhancement and reconstruction images were different from the blood vessel relationship.Therefore,plain CT scan and multi-phase enhanced CT scan are helpful for the differential diagnosis of them.