慢性肺炎性肿块CT表现与病理对照的探讨

目的：探讨肺炎性肿块的CT表现与病理类型的关系及CT在诊断中的价值。方法：回顾性分析了48例经病理组织学或细胞学证实的肺炎性假瘤(24例)、限局性机化性肺炎(18例)以及限局性化脓性肺炎(6例)的临床、CT资料。结果：24例炎性假瘤中，20例直径在2～5cm之间，多呈圆形或类圆形，80％肿块密度均匀；3例行增强扫描，1例呈均匀强化，2例周边强化，中心低密度，5例可见“桃尖征”。18例限局性机化性肺炎中，16例邻近胸膜面，病变形态不规则，13例见向心性弓形凹陷及尖角状突起，3例可见气管血管束向病灶聚拢。6例限局性化脓性肺炎均邻近胸膜面，2例见小圆形透光区，无气液平面，3例行增强扫描，1例周边强化，2例除低密度区及空洞外，实性部分呈厚壁强化，6例均未见气管血管束聚拢征象。结论：肺部炎性肿块结合临床及CT表现大多数可做出正确诊断，表现不典型者，可行CT导引下穿刺活检。

Chronic pulmonary inflammatory masses:comparation of CT features with pathology

Objective:To investigate the relation between CT findings and pathology, and the value of CT diagnosis in pulmonary inflammatory masses.Methods:Clinical and CT findings of 48 cases of pulmonary inflammatory masses including pulmonary pseudotumor (n=24)?localized organizing pneumonia (n=18) and localized purulent pneumonia (n=6) were analyzed retrospectively.Results:Most (>80%) pseudo tumor were round or roundlike,had sharp margins and homogeneous density,the size varied from 2 to 5 cm in diameter.16 lesions of localized organizing pneumonia were near the pleural surface.13 of them had inward bow indentations.3 of them had bronchovascular bunches.Six localized purulent pneumonia were all near the pleural surface,and had no bronchovascular bunches in all the cases.Conclusion:CT findings combined with clinical of most pulmonary inflammatory masses can be diagnosed.Untypical cases of CT findings can be biopsied by CT guide.