球性肺炎的多层螺旋CT表现及误诊分析

MSCT Diagnosis and Misdiagnosis Analysis of Spherical Pneumonia

目的分析球性肺炎的多层螺旋CT的特征性影像学表现,探讨其误诊的原因。方法回顾性分析经病理(手术或穿刺)、临床观察证实、影像学误诊的17例球形肺炎CT表现。结果病灶大多位于肺野的背侧,靠近或贴近胸膜,均单发,14例病灶为圆形或类圆形,3例为三角椎形。可见"局部充血征"、"晕征"、"刀切征"。9例误诊为周围型肺癌,7例误诊为肺结核,1例误诊为肺转移瘤。结论球性肺炎MSCT表现有一定特征性,CT多征象综合分析,并结合临床多能做出正确诊断,部分不典型病灶影像学诊断困难,应积极进行穿刺活检。

Objective To analyze the MSCT features of spherical pneumonia, and discuss the reason of the diagnosis. Methods MSCT features of 17 cases with spherical pneumonia proved by pathology （orperation or biopsy）, clinic information and misdiagnosis were analyzed retrospectively. Resyuts The sit of spherical pneumonia most located in the back of the lung and near the pleura, single in number 14 lesions were oval or spheroid, 3 lesion were triangular con or square ＂localized plethora sign＂, ＂halo sign＂, ＂cutting sign＂. 9 cases were misdiagnosed as peripheral lung cancer, 7 cases were misdiagnosed as pulmonary tuberculosis, 1 cases was misdiagnosed as pulmonary metastasis. Conclusion Spherical pneumonia has some specific MSCT features correct diagnosis depends on CT features and clinical date, biopsy is necessary when it is difficult to diffierertiate diagnodid .