结节周围支扩征在CT诊断肺结核球中的价值

The Value of the Peripheral Bronchiectasis Sign in Diagnosis of Lung Tuberculoma on CT Imaging

目的 探讨结节周围支扩征 (PBS)诊断肺结核球的价值。方法 选择直径 <4cm的孤立性肺结节、有完整CT资料并经最后证实的肺结核球 2 7例和周围型肺癌 35例。在CT片上观察其结节周围 1cm范围内有无扩张的支气管 (即周围支扩征 )。结果 6 2例中 ,在高分辨率CT片 (HRCT)上发现周围支扩征 13例。其中 11例为结核球 ,2例为周围型肺癌 ,两者间存在显著性差异 (P <0 .0 0 1)。用周围支扩征诊断结核球的敏感性为 40 .7% ,特异性为 94.3%。结论 结节周围支扩征对肺结核球的诊断有较大的价值。但该征在常规CT上不易显示 ,故对一些肺结节有必要作高分辨率CT扫描。

Objective To evaluate diagnostic value of the peripheral bronchiectasis sign (PBS) in diagnosis of lung tuberculoma. Methods Sixty two of solitary pulmonary nodules were chosen among standard CT and high resolution CT( HRCT) , including 27 tuberculomas and 35 peripheral lung cancers which were proved by operations and pathology or follow up. The CT films were carefully analysed by three experienced doctors to assure whether there was PBS in an area of 1 cm around the nodules or not. Results Among 62 nodules, 13 PBS was found on HRCT films, which includes 11 tuberculomas and 2 peripheral lung cancers, with a significant differences between them ( P <0.001). With PBS, the sensitivity of tuberculoma diagnosis was 40.7% and the specificity was 94.3% . Conclusion It is obvious that the PBS around nodules is of important value to tuberculoma diagnosis and different diagnosis. Furthermore, it is very necessary to use HRCT in the lung nodules CT scan. [