MSCT薄壁囊腔型肺癌、薄壁空洞性肺结核影像学特征及鉴别诊断

MSCT Imaging Features and Differential Diagnosis of Lung Cancer with ThinWalled Cavity and Thin-Walled Cavitary Tuberculosis

目的 对比薄壁囊腔型肺癌、薄壁空洞性肺结核MSCT征象,分析薄壁囊腔型肺癌和薄壁空洞性肺结核影像特征的异同。方法 回顾性分析本院2017年4月至2019年9月经手术病理证实的34例薄壁囊腔型肺癌患者和33例薄壁空洞性肺结核患者的临床资料,比较肺癌组和结核组患者的MSCT征象,对两组患者病灶进行CT定量分析。结果 肺癌组患者的病灶及含气腔隙大小显著大于结核组患者,含气腔隙壁厚显著低于结核组(P<0.05),肺癌组患者病灶位置多分布在中下肺,形态呈圆形或类圆形,肿瘤边缘多见分叶状,边界光整,多囊、“磨玻璃”征、胸膜“凹陷”征,形态学分型以Ⅵ型多见;结核组患者病灶位置多分布在上肺,形态多呈圆形或类圆形,肿瘤边缘多见“短毛刺”征和“尖角”征,边界多清楚毛糙,单囊,很少见“磨玻璃”征、胸膜粘连,形态学分型以Ⅲ型多见。结论 壁薄囊腔型肺癌和壁薄空洞性肺结核的MSCT征象具有一定的差异,分析其影像学特征可有效提高MSCT对两种疾病的诊断准确率。

Objective To compare the MSCT signs of lung cancer with thin-walled cavity and thin-walled cavitary tuberculosis, and to analyze the similarities and differences of image features between lung cancer with thin-walled cavity and thin-walled cavitary tuberculosis. Methods The clinical data of 34 patients with lung cancer with thin-walled cavity and 33 patients with thin-walled cavitary tuberculosis confirmed by operation and pathology from April 2017 to September 2019 were retrospectively analyzed. The MSCT signs of patients in the lung cancer group and the tuberculosis group were compared, and the lesions of the two groups were quantitatively analyzed by CT. Results The size of the lesions and air-containing lacuna in the lung cancer group was significantly larger than that in the tuberculosis group. The wall thickness of the air-containing lacuna was significantly lower than that of the tuberculosis group(P<0.05). In the lung cancer group, the lesions were mostly distributed in the middle and lower lungs. The shape was round or round, and the margins of the tumor were mostly lobulated, border was with smooth, with polycystic sign, ground glass sign, pleural indentation sign,and morphological classification was more common in type Ⅵ.In the tuberculosis group, the lesions were mostly distributed in the upper lung, and the shape was mostly round or round. The edge of the tumor was mostly short burr and sharp angle. The boundary was clear and rough, single cyst.Ground-glass signs and pleural adhesions were rarely seen, and morphological classification was more common in type Ⅲ. Conclusion The MSCT signs of lung cancer with thin-walled cavity and thin-walled cavitary tuberculosis have some differences. The analysis of imaging features can effectively improve the diagnostic accuracy of MSCT forthe two diseases.