螺旋CT在继发性肺结核与肺癌鉴别诊断中的价值

Differential diagnostic value of spiral CT in secondary tuberculosis and lung cancer

目的:分析继发性肺结核与肺癌的螺旋CT影像特点,总结螺旋CT在其鉴别诊断中的应用价值。方法:回顾分析经病理及临床证实100例继发性肺结核及20例肺癌的影像学特征,评价其影像表现差异。结果:100例肺结核中,结核球12例,其中直径2.0-3.0cm圆形、椭圆形、孤立性结节影8例,直径>3.0cm,出现分叶、毛刺、空泡、胸膜凹陷等征象的不典型结核瘤4例,易误诊为肺癌;空洞36例,呈圆形或类圆形,薄壁空洞22例,厚壁空洞14例;合并支气管内膜结核20例,合并胸腔积液15例,合并纵隔、肺门淋巴结核17例。20例肺癌,肺内肿块14例,12例外壁呈分叶状,8例有放射状短毛刺,3例偏心性空洞,肺门肿块6例,有4例合并肺结核。结论:螺旋CT在继发性肺结核与肺癌鉴别中具有重要价值。

Objective：To analyze the spiral CT imaging characteristics of secondary tuberculosis and lung cancer,and differential diagnosis value of spiral CT.Methods： The CT characteristics of 100 cases of secondary tuberculosis and 20 cases of lung cancer confirmed by pathology and clinical were retrospectively analyzed.Results： Of the 100 secondary tuberculosis cases,there were tuberculosis tumor 12 cases,diameter of 2.0 to 3.0 cm circle,elliptic,isolation of nodules 8 cases,3.0 cm in diameter,appear points leaves,burr,empty bubble,pleural sag etc signs of not typical of tuberculosis tumor 4 cases,easily misdiagnosed as lung cancer.Empty 36 cases were round or kind of circular,thin wall empty 22 cases,thick wall empty 14 cases;merger bronchial lining tuberculosis 20 cases,merger pleural effusion 15 cases,merger mediastinum,lung door scrofulous 17 cases.Of 20 lung cancer cases,there were lung tumor 14 cases,12 exception wall was the lobulated,radial short burr 8 cases,eccentric empty 3 cases,hilar tumor 6 cases,have 4 cases amalgamative tuberculosis.Conclusion： Spiral CT in secondary tuberculosis and lung cancer has important value to differential diagnosis.