肺空洞性病变的CT定量分析

Quantitative analysis on CT findings of intrapulmonary cavitary lesions

目的定量分析不同病理基础肺空洞的CT表现及其鉴别诊断。方法回顾性分析经临床与病理证实的98例各类肺空洞病变的CT资料,其中,肺脓肿17例,肺结核30例,肺霉菌病3例,原发性肺癌37例,转移性肺癌8例,Wegner's肉芽肿3例。逐例记录病灶大小、形态、边缘、密度,对病灶大小及空洞壁的CT值变化进行测量。比较不同病变空洞壁厚度和CT值强化幅度。t检验及χ2检验统计分析相关数据。结果各组不同病变的空洞其内、外壁不同形态出现率比较及空洞内容物出现率均无显著差异(P>0.05);偏心空洞以肺癌为主,占70%,与其他各组比较相差显著(P<0.01);肺癌与各组间空洞壁厚度相差显著(P<0.05),空洞壁CT值强化幅度在肺癌与其他各组比较相差显著(P<0.05)。结论肺部空洞性病变有无偏心、空洞壁CT增强幅度及空洞壁厚度对鉴别良、恶性空洞有意义。

Objective To analyze quantitatively the CT findings and differential diagnosis of intrapulmonary cavitary lesions which was secondary to benign and malignant diseases. Methods CT data of 98 patients with clinically and pathologically proved intrapulmonary cavitary lesions, of whom, lung abscess （ n = 17）, tuberculosis （ n = 30）, mycosis infection （ n = 3）, primary lung cancer（ n = 37 ）, metastatic tumor（ n = 8）, and Wegner＇s granulomatosis（ n = 3）were analyzed retrospectively. Morphologic features of the cavitary lesions such as size, shape, border and density were recorded, and CT value changes before and after contrast enhancement were measured for each case. The wall thickness and enhanced CT value amplitude of benign versus malignant cavities were compared. The correlative data in all patients were statistically analyzed by t and X^2 test. Results For the internal and external wall shape and contents of the cavitary lesions,there were not significant difference between different primary diseases（ P 〉 0. 05）. Lung cancer mostly appeared as eccentric cavities（70% ）, compared with other groups, the difference was significant（ P 〈 0. 01 ）, The wall thickness of cavilary lesions between lung cancer and other groups was significant difference（ P 〈 0. 05）. The enhanced CT value of cavitary walls between lung cancer and other groups was also significant difference（ P 〈 0. 05）. Conclusion Whether intrapulmonary lesions appearing as eccentric cavity, whether cavitary walls having higher CT value and more obvious thickening are helpful to differentiate lung cancer from benign lesions.