肺部孤立性结节性炎性病变的CT表现及诊断

CT Manifestation and Diagnosis of Solitary Inflammatory Nodules of the Lung

目的提高对肺部孤立性结节性炎性病变的认识,提高对该病的正确诊断率。方法肺部孤立性结节性炎性病变26例,其中手术治疗6例,经皮CT引导下穿刺活检4例,抗炎治疗后CT随访复查16例。所有病灶部位均作2-5mm薄层CT扫描。结果(1)病灶大多位于肺的背侧,靠近或紧贴胸膜。(2)类圆形或不规则形。(3)病灶附近胸膜反应明显。(4)病灶密度多较均匀,中央密度较高,边缘密度低,可见"晕征""、刀切征",少数有透亮影。结论肺部孤立性结节性炎性病变的CT征象具有一定特征性,多征象综合分析,并结合临床,多能做出正确诊断,抗炎治疗观察2-3周对于鉴别诊断有价值,不易鉴别者应活检以尽早确诊。

Objective To study CT findings of solitary inflammatory nodules of the lung,and prove CT diagnostic accuracy. Methods In 26 cases with solitary inflammatory nodules of the lung,6 cases were treated with surgery,four cases were punctured with CT guided biopsy, and others with anti-inflammatory agents under being followed up with CT. All were scanned with 2-5mm thin slice CT. Results （ 1 ）Lesions mostly located in the back of the lung and near the pleura. （2）The lesions showed round-like or irregular margin. （3）There were marked pleural reaction around the lesions. （4）Most lesions with homogeneous density, the central part of the lesions showed high density, while periphery part of lesion were low in density. ＂halo＂, ＂sharpen rim perpendicular to pleura＂ signs;there was empty space in few cases. Conclusion Solitary inflammatory nodules of the lung have some CT features. Diagnosis depends on CT features and clinical data, treatment with antibiotic therapy for a period of 2-3 weeks and helps to differentiate these diseases, biopsy is necessary when it is difficult to differentiate diagnosis.