高分辨率CT对球形肺炎的诊断及鉴别诊断价值探讨(附21例分析)

目的:分析球形肺炎的高分辨率CT(HRCT)的表现,以便与肺部其它球形病灶进行鉴别诊断。方法:搜集我院2005/2009年间21例球形肺炎患者临床及HRCT资料进行回顾性分析。结果:21例球形肺炎的主要CT表现:①圆形或椭圆形致密影,大小2-4.5cm,密度均匀或不均匀;②部分病灶边缘见毛刺影,较粗长;③部分病灶周围胸膜增厚,所属支气管管壁增厚、管腔扩张;病灶近肺门侧有迂曲、增粗的条索状血管影;④消炎治疗后见病灶吸收,最后除残留纤维条索状影外,个别病例留下机化性不规则致密影;⑤本组21例未见明显肺门及纵膈淋巴结肿大。结论:结合临床相关资料HRCT是球形肺炎诊断与鉴别诊断的重要方法。

Objective： To analyze the HRCT imaging features of spherical pneumonia （SP） and to differentiate it from other spherical lesions. Methods：21 cases of SP clinically and pathologically proved from 2005 to 2009 year in our hospital were evaluated retrospectively. Results： The major HRC＇T features： （ 1 ） Most lesions were round or oval. The size was approximately from 2 to 4.5cm. The density was homogeneous or inhomo- geneous. （2）some lesions had burrs on the edge,long and rough. （3）some lesions had thickening part of the surrounding pleural.Their bronchial wall were thiciekening and lumen was expanding.There were tortuous and thickened cordlike vascular shadow close to the hilar side of lesion. （4）After anti- inflammatory treatments, some lesions were absorbed. （5）There were no hilar and mediastinal lymph nodes enlargement in 21 cases. Conclusion： HRCT is a critical method for diagnosis and differential diagnosis of SP.