结节型局灶性机化性肺炎的CT表现

目的:分析结节型局灶性机化性肺炎的CT表现,探讨与周围型小肺癌的鉴别诊断。材料和方法:回顾性分析经手术病理证实的12例表现为孤立性肺结节的局灶性机化性肺炎的CT表现。结果:10例病灶邻近胸膜,其中8例合并相邻胸膜增厚粘连,6例位于各胸膜交界区。病灶边缘光整3例,毛糙9例,边缘有粗长毛刺征2例,细短毛刺征5例,分叶征3例,血管纠集征4例,棘状突起征2例;7例病灶内密度均匀,支气管空气征2例,空泡征1例,病灶内液化2例;强化明显6例,病灶明显强化率为54.5%;病灶周缘肺内渗出灶3例,卫星灶1例;病灶同侧少量胸腔积液3例。结论:NFOP的CT表现上除与胸膜关系密切外,其他表现常与SPLC相似,在长期密切随访观察病灶变化的基础上,行经皮肺穿刺活检以及创伤较小的电视胸腔镜下目标肺楔形切除是有必要的。

CT Features of Nodular Focal Organizing Pneumonia

Purpose:To analyze CT features of nodular focal organizing pneumonia(NFOP)and to investigate dif-ferential diagnosis with small peripheral lung cancer(SPLC).Materials and Methods:CT features of NFOP in12pathologically-proved cases were retrospective studied.Results:Ten lesions were located near the pleural surface.Among them,eight cases demonstrated pleural thickening with adhesion and six cases located in the pleural junctional zone.The lesions demonstrated smooth margin in3,coarse margin in9,coarse long spiculation in2,thin short spiculation in5,lobulation in3,convergence of vessels in4and spiculate protuberance in2.Seven lesions were homogeneous density.Lesions with inhomogeneous density demonstrated air bronchogram in2,vacuole sign in1and liquefaction in2.Six lesions(54.5%)were obviously enhanced on contrast enhanced CT scan.Surrounding lung field of the lesions can see exudation lesions in3,satellite lesions in1.Three cases were found small amount of pleural effusion in homonymy of the lesions.Conclusion:NFOP is closely related to the pleural,but frequently CT findings of the lesions is similar to SPLC.Biopsy by utilizing percutaneous puncture and video-assisted thora-coscopic surgery along with long term follow-up for NFOP is essential.