摘要
目的总结32例肺炎性假瘤的CT表现,以期提高对该病的诊断水平。方法回顾性分析32例经手术或穿刺活检后病理证实的肺炎性假瘤的CT征象,全部病例均行CT平扫,20例加做CT增强扫描。结果全部病例为单发病灶,位于胸膜下28例(87.5%),呈圆形或类圆形15例,楔形或三角形8例。全部病灶内部无一例出现钙化,4例病灶内见空气支气管征,"空泡征"4例,3例形成多个小空洞,3例病灶内有坏死;增强扫描,病灶明显均匀强化3例,明显不均匀强化4例,中度不均匀强化10例,轻度不均匀强化3例。12例病灶周围有长毛刺征,3例病灶可见"桃尖"征,2例病灶见"平直"征,"晕征"3例,4例病灶周围见血管集束征。5例病灶周围肺后和/或外带出现胸膜肥厚粘连,1例出现纵隔内淋巴结肿大,2例合并胸腔积液。CT正确诊断10例,误诊为肺癌17例,误诊为结核瘤4例,误诊为韦格纳肉芽肿1例。结论肺炎性假瘤的部分CT表现有一定的特征性,全面综合分析CT表现并结合临床病史有助于正确诊断。
Objective To study the CT diagnostic charaeteristics of puhnonary inflammatory pseudotumor. Methods CT scans of 32 patients with histologically confirmed pulmonary inflammatory pseudotumors were analyzed retrospectively and compared with pathological findings. Results All 32 lesions were solitary with 28 （87.5%） located near the pleura. 15 presentod as round or oval masses and 8 lesions were wedge- or triangular-shaped. There were air bronchogram （4）, vacuoles （4）, muhiplc small cavities （3）, and necrosis （3）. No calcification was found in any of the lesions. Contrast enhancement was marked and uniform （3）, marked and heterogeneous （4）, moderate and heterogeneous （10）, mild and heterogeneous （8）. The margins were spiculated （! 2）, peach-tip （3）, smooth regular （2）, or associated with a halo （3） and converging blood vessels （4）. Other findings included adjacent pleural thickening （5）, mediastinal lymphadenopathy （1） and pleural effusion （2）. Ofall 32 cases, 10 （31.6%） were correctly diagnosed on CT, 17 （53.1%） were misdiagnosed as lung cancer, 4 （12.5 %） were misdiagnosed as tuberculomas, 1 （3.1%） was misdiagnosed as Wegener granulomatosis. Conclusion Comprehensive analysis of characteristic CT findings combined with clinical history can improve diagnostic accuracy of inflammatory pseudotumor.
出处
《影像诊断与介入放射学》
2011年第3期186-189,共4页
Diagnostic Imaging & Interventional Radiology
关键词
肺
炎性假瘤
体层摄影术
X线计算机
Lung
Inflammatory pseudotumor
Tomograpy, X-ray eomputed
