胆固醇性肺炎的CT诊断

目的通过分析胆固醇性肺炎患者的CT表现从而探讨采用CT诊断胆固醇性肺炎的可能性。方法随机选取2006年3月至2010年12月该时期来我院就诊的并经病理证实的胆固醇性肺炎患者25例为研究对象,其中男患者18例,女7例,年龄都在10~73岁,平均年龄在54.5岁,所有的病例都采用螺旋CT进行扫描,其中采用平扫的患者2例,平扫加增强扫描的有23例,后分析这些患者的CT征象其中包括分析其病变数目、大小以及形态、边缘、密度以及强化后的强化程度等从而探讨出才用CT诊断的可能性。结果 CT图上显示结节肿块型的16例,斑片型5例,混合型4例。结节肿块类型的患者比较多的可见分叶,周围有毛刺或晕征中心可见低密度,增强后得到全瘤或环状的不均匀强化。而斑片型则可见边缘清晰或磨砂玻璃样大小不一的片状影,其中有1例患者双肺有较多的片状影并可见中度均匀的强化,而混合型患者则有囊肿结节、空洞病灶旁可见实变或磨砂玻璃影,软组织肿块或片状病灶内则可见支气管充气、充液征象。肺门及纵隔淋巴结肿大的16例患者术后被证实为炎性反应性病变,4例患者胸腔出现少量积液,3例患者的病灶内可见少量圆点状或不规则钙化灶。结论患者CT图像出现病灶内支气管气像、充液征或周围大范围有磨砂玻璃样渗出或双肺多发斑片状的病灶时可诊断该患者为胆固醇炎症,肿块或者混合型大病灶内的中心区有超过半径的规则类圆形或多房的低密度灶并周围有环靶征强化的CT征象时对诊断胆固醇性肺炎具有一定的临床诊断意义,值得进一步探索。

CT Diagnosis of Cholesterol Pneumonia

Objective To analyze the CT findings of the cholesterol in patients with pneumonia to explore the possibility of using CT diagnosis of cholesterol pneumonia.Method Randomly select from March 2006 to December 2010 the period to our hospital and of cholesterol pneumonia patients with pathologically confirmed 25 cases for the study,including 18 cases of male patients and 7 females,aged in 10-73 years old,the average age of 54.5 years,all cases using helical CT scanning,which uses plain 2 patients,23 cases of plain and enhanced scan,after the analysis of these patients with CT signs including analysis of its lesion number,size,and shape,edge density and enhanced degree of enhancement to explore the possibility of only with CT diagnosis.Results CT nodular mass type 16 cases,5 cases of patches,mixed four cases shown on the display.Nodular mass type of patients more visible leaf around glitches or halo sign center visible low density,the full tumor or cyclic enhanced heterogeneous enhancement.Plaques type visible edge of clear or frosted glass sample sizes of patchy patients lungs more patchy and visible moderate homogeneous enhancement,while patients with mixed cysts knot section,cavitary lesions seen consolidation or frosted glass shadow next soft tissue mass or flaky lesions visible air bronchogram,fluid-filled signs.Hilar and mediastinal lymph nodes in 16 patients were confirmed inflammatory response lesions,4 patients with pleural small amount of fluid in 3 patients the lesions seen in a small number of dot-like or irregular calcification.Conclusion CT images intralesional bronchial air like a wide range of fluid-filled levy or around a frosted glass-like exudative or multiple lung hair patchy lesions of the patients can be diagnosed as cholesterol inflammation,lumps or mixed intralesional the central area of low-density lesions of the rule class more than the radius of the circular or multi-room and around the ring the target sign strengthen the CTsigns in the diagnosis of cholesterol pneumonia clinical diagnostic significance,worthy of further exploration.