球形肺炎—炎症还是梗死

Spherical pneumonia—inflammation or infarction

目的 研究球形肺炎的CT表现及其发病机制。方法 结合复习有关文献 ,对 2 1例经临床或手术病理证实的球形肺炎的临床及CT资料进行研究分析。结果 球形肺炎的CT表现与一般肺内炎症有很大不同 ,主要表现为位于肺野外围的楔形病变 ,病变外缘与邻近胸膜以广基相连 ,邻近胸膜广泛均匀性增厚 ,病变与肺门间有多条粗大血管相连。结论 绝大多数球形肺炎可能不是炎症而是段以下肺动脉栓塞所致的肺梗死改变。

Objective: To study the CT findings of spherical pneumonia and explore its pathological mechanism. Methods: Combining with the review of the relative literature,the CT and clinical data of 21 cases with spherical pneumonia clinicaly and/or pathologically proved were analysed. Results: The spherical pneumonia differed obviously from common pneumonia in both CT and clinical manifestations.The main CT findings of the spherical pneumonia were as follows:(1)The cone shaped lesion located in the peripheral lung.(2)The exterior margins of the lesion were widely connected with the near pleura. (3) The involved pleura was thickened evenly and extensively.( 4) There usually were several blood vessels between the lesion and the hilus. Conclusion: Most spherical pneumonia may not be inflammation but infarction caused by the embolism of subsegmental pulmonary artery.