肺炎性假瘤的CT诊断(附30例报告)

CT diagnosis of pulmonary inflammatory pseudotumor(a report of 30 cases)

目的探讨肺炎性假瘤的CT诊断及思路。方法回顾性分析30例经穿刺活检、手术病理证实的肺炎性假瘤的CT平扫表现及有关临床资料。结果本组肺炎性假瘤发生在右下叶8例,右上叶7例,中叶者3例;左下叶8例,左上叶4例。病灶密度均匀24例,病灶呈类圆形或椭圆形者26例,团片状3例,哑铃状1例;边缘出现“桃尖征”9例,周围长毛刺征6例,支气管气象4例,空洞征4例,沙砾样钙化2例,空泡征1例;21例病灶与相邻组织的界线清晰并有轻度压迫征象,17例出现相邻胸膜肥厚粘连,3例纵隔内见肿大淋巴结,相邻骨质未见破坏。结论CT平扫对肺炎性假瘤的诊断有一定价值,但也有明显局限性,应完善CT增强扫描检查,此外,CT引导下肺穿刺活检术是作出诊断的重要手段。

Objective To research the CT diagnosis feature and methods of pulmonary inflammatory pseudotumor. Methods CT findings and some clinical information of 30 cases through punctured biopsy or postoperative pathology confirmed to be pulmonary inflammatory pseudotumor were retrospectively analysed. Results CT plain scan showed 8 cases in lower lobe,7 cases in upper lobe, and 3 cases in middle lobe of right lung;and 8 cases in lower lobe,4 cases in upper lobe of left lung,24 cases uniformity density,26 cases a solitary round or oval mass with regular margin,3 cases sheet shape, 1 case dumbbell shape ,9 cases peach-tip sign,6 cases long spiculation sign,4 cases air bronchogram,4 cases inanition sign,2 cases calcifications, 1 case vacuole sign ;21 cases borderline was in focus and gently oppressed it＇s surrounding tissue, 17 cases pleural thickening and adhension,3 cases mediastinal swelling lymph, while no bone destruction. Conclusion CT plain scan was valuable and limited on the diagnosis of pulmonary inflammatory pseudotumor, and contrast enhancement of computed tomography is necessary. Furthermore, punctured biopsy with the help of CT examination is important to its diagnosis.