肺炎性假瘤的CT诊断

目的 提高对肺炎性假瘤的ＣＴ表现的认识,以便与其它球形病灶,特别是与肺癌病灶做出较正确的鉴别诊断。方法 作收集近年来经手术和或）纤维支气管镜活检病理证实的１６例肺炎性假瘤,回顾性分析其ＣＴ表现。结果 主要的ＣＴ表现是：（１）病变呈椭圆形４例,三角形或不规则形４例,可见锯齿状或分叶７例：靠近胸膜的病灶,其两侧缘垂直于胸膜呈刀切样平直边缘５例。（２）病变中央密度高。边缘低,呈“晕圈样”改变７例。５例可见支气管充气征。（３）病灶周围,胸膜反应显,广泛增厚１０例;“卫星灶”６例：胸膜凹陷３例;病变周围血管纹理增多,增粗９例,结论 ＣＴ检查有助于明确炎性假瘤的诊断,“刀切样征”和“晕圈样”在诊断与鉴别诊断中有较高的价值。

CT diagnosis of pulmonary inflammatory pseuodo-tumor

Purpose: To study the CT features of pulmonary inflammatory pseudo - tumor in order to make an accurate diagnosis and differentiation. Methods :CT images in cases with this disease confirmed by surgical or bioptical histopathology were retrospectively studied. Results: The main CT findings were as follows: (1)The margin of the lesions was very varied and confusing, such as spherical(n = 4) .triangle or irregular (n = 4) , serrated or lobulated(n = 7) , straight cut edge presenting a square sign(n = 5) . (2)The density of the margin of the lesion was lower than that at the central area,sometimes presenting a halo- like appearance(n = 7) .Air bronchogran(n = 5) and extensive pleural thichenings(n= 10),satellite lesion (n = 6),pleural retractions(n = 3) intensified vascular markings surrounding the lesion(n = 9) were demonstrated in this series. Conclusion:CT examination is helpfule to the correct diagnosis of pulmonary post - inflammation pseudotumor. "Straight cut edge/ and" halo - like signs would be valuable in its diagnosis and differentiation.