中央型肺癌与支气管结核支气管改变的多层螺旋CT表现

目的探讨多层螺旋CT（MSCT）支气管改变对中央型肺癌和支气管结核的鉴别诊断价值。方法对26例中央型肺癌和11例支气管结核患者进行了MSCT检查,分析肺癌与结核的支气管改变,比较两者间的差异;对9例中央型肺癌患者进行了影像与病理对照。结果中央型肺癌支气管受累较局限,而支气管结核支气管广泛性受累常见（P〈0.05）,支气管广泛受累（≥3支）在结核的发生率明显高于肺癌（P〈0.01）;结核的管壁增厚以全层为主,肺癌的管壁以全层或以外壁增厚为主（P〉0.05）;肺癌的管腔内表面光整,而结核往往欠光整（P〈0.05）。结论MSCT支气管改变有助于中央型肺癌与支气管结核的鉴别诊断。

Multi-slice spiral CT study on the bronchial changes of central lung cancer and bronchial tuberculosis

Objective To explore the differential diagnostic value of bronchial changes on multislice spiral CT （MSCT） in central lung cancer and bronchial tuberculosis. Methods 26 patients with central lung cancer and 11 patients with bronchial tuberculosis were scanned using MSCT, and bronchial changes were analyzed in order to compare the difference of CT bronchial changes between central lung cancer and bronchial tuberculosis. Meanwhile, CT-pathological study was done on 9 patients with central lung cancer. Results Bronchial abnormality among bronchial tuberculosis was more extensive than that among central lung cancer （P 〈0.05）. There was a significant difference in bronchial extensive abnormality rate （≥3 branches） between tuberculosis and lung cancer （P 〈0.01）. Bronchial wall full-thickening was common in tuberculosis, but bronchial wall may display full-thickening or ectotheca thickening in lung cancer. The difference in full-thickening and ectotheca thickening between tuberculosis and lung cancer was not significant （P 〉0.05）. Smooth bronchial lumen was common in lung cancer, whereas coarse bronchial lumen was more common in tuberculosis （P 〈0.05）. Conclusion MSCT bronchial changes are helpful to differentiate central lung cancer and bronchial tuberculosis.