33例球形肺炎的临床和影像学特征分析

目的　探讨球形肺炎的影像学特点。方法 对33例经临床或病理确诊的球形肺炎进行回顾性分析。结果 球形肺炎X线主要表现:(1)圆形或椭圆图形;(2)病灶中央密度高,边缘密度较低,呈晕圈样改变;(3)病灶纹理明显增粗,即“胡须征”;(4)早期应用有效抗生素常可完全消失。CT主要表现:(1)球形肺炎CT层面多呈楔形或方形;(2)病灶边缘毛糙,边缘不规则,但较模糊;(3)病变周围血管纹理增粗,增多,但无僵直;(4)好发于背段或外侧野;(5)累及胸膜时接触面广且厚;(6)密度均匀,可有空洞,无钙化。结论 球形肺炎有一定的影像学特点,但有时其征象与肺结核,周围形肺癌鉴别困难,需依赖临床及病理。

Analysis of clinical and radiographic feathers of 33 cases spherical pneumonia

Objective To study radiographic features of spherical pneumonia and to differentiate it from other spherical lesion and reduce misdiagnosis. Methods 33 cases of Spherical pneumonia clinically diagnosed were analysed retrospectively. Results All of the patients’ chest radiographs features:(1)The size of the lesion in nice cases varied from 2 to 4cm (average 2cm), the lesion presented round or oval shape. (2)Most lesions were located in the peripheral lung parenchyma near the plcural surface;(3)The density at the margin of the lesion was lower than that at the central area, sometimes prescnting a halo like appearance;(4)After short term anti inflammatory therapy, most lesions were obviously reduced in size. While the main CT findings were as follows:(1)The lesion presented a triangular shapc;(2)Rough margins with illdefined outline could be senn;(3)Extensive pleural thicken;(4)The lesions were surrounded by small patches of slightly high density and (or) intensified vascular makings;(5)The density of lesion was cvcn, of which had cavity, no calcification.Conclusion Spherical pneumonia has some specific radiographic features, but cometimes radiographic findings of the lesion is similar to peripheral lung cancer and TB, of which diagnosis must be based on clinical feathers and pathology.