探讨球形肺炎多样化的CT表现及其诊断价值

目的:探讨球形肺炎多样化的CT表现及其诊断价值。材料与方法:抽取在我院经CT检查发现,并经临床观察、手术或穿刺活检证实的球形肺炎患者60例,对其CT表现及诊断进行回顾性分析。结果:60例球形肺炎患者的CT诊断准确率为96.67%;其CT表现主要为:病灶多位于肺野背侧,沿支气管血管束靠近胸膜分布,其所属支气管壁非狭窄性均匀广泛增厚;病灶呈方形、球形或类球形;中央密度高,边缘密度低,呈"晕圈征",部分病灶内部可见空气支气管征;增强扫描病灶呈不均匀强化征象,肺门侧血管增多、增粗、扭曲,但无僵直及牵拉;垂直于胸膜侧边缘平直,呈刀切样,其他边缘呈较模糊的不规则或锯齿状改变,并可见浅淡的小片状高密度影;局部及周围胸膜肥厚;纵隔、肺门无明显淋巴结肿大;抗炎治疗后病变疏散或明显缩小。结论:球形肺炎虽然具有一定的特征性CT表现,但也具有多样化特征,只有认真的综合分析其影像征象,并结合临床及进行动态观察,才能有效提高诊断准确率。

The Diuerse CT Manifestation and Diagnostic Value of Spherial Pnellmonia

Purpose： To investigate the diverse CT manifestations of spherical pneumonia and its diagnostic value.Materials and Methods： 60 patients in our hospital were diagnosed as spherical pneumonia by CT examination,then clinical observation,surgery or needle biopsy were made to them for comparison. All their CT findings and diagnosis were retrospectively analyzed. Results： CT diagnostic accuracy of the 60 patients with spherical pneumonia was 96. 67%; CT manifestations of the patients mostly were： Lesions were located in back side of lung field close to the pleura distributed along the bronchial vascular bundle,the bronchial wall which they belongs to thickened non-stenoticly,uniformly and widely; Lesions were square,spherical or spherical; Central density of the lesions is high but its edge density is low,which showed a＂haloing＂signs,and the bronchial air signs can be found inside some lesions; Enhanced scan of lesions showed heterogeneous enhancement signs,the blood vessels of hilar side increased,thickened,distorted,but didn＇t appear stiff and traction; the side edges perpendicular to the pleural was flat and straight like a knife incision,Other edges showed more obscure irregular or jagged change and visible light and small pieces of high density; Local and surrounding pleural thickened; Mediastinal and hilar had no obvious lymphadenopathy; lesion evacuated or significantly reduced after anti-inflammatory treatment. Conclusion：The spherical pneumonia not only has certain characteristic CT findings,but also has diverse characteristics,Only to analyze the images signs seriously and comprehensively,to make dynamic observation combined with clinical can effectively improve diagnostic accuracy.