肺结核瘤的常规胸部螺旋CT与高分辨CT对比研究

Comparative Analysis between Spiral CT and High-Resolution CT on the Diagnosis of Lung Tuberculoma

目的 评价常规螺旋CT(SCT)与高分辨CT(HRCT)对结核瘤的诊断价值。方法 回顾性分析 40例肺结核瘤的SCT及HRCT扫描资料 ,观察其结节的轮廓、边缘、内部特征及周围情况 ,比较两种检查对结核瘤的显示效果。结果 SCT与HRCT显示结节内钙化分别为 2 7.5 %和 6 0 .0 % ,结节周围支扩征分别为 2 .5 %和 42 .5 % ,边缘毛刺征分别为 10 .0 %和 2 7.5 % ,边缘光滑分别为 5 7.5 %和 47.5 % ,卫星病灶分别为 37.5 %和 40 .0 % ,胸膜增厚伴凹陷分别为 37.5 %和 40 .0 %。如以钙化、卫星病灶及周围支扩征作为肺结核的特征 ,SCT的诊断符合率为 45 .0 % ,HRCT诊断符合率为 95 .0 %。结论 肺结核瘤的许多征象在HRCT上的出现率明显高于SCT ;因此 ,HRCT作为SCT扫描的补充手段对于一些结核瘤的诊断是必不可少的。

Objective To evaluate the diagnostic value of spiral CT(SCT) scan and high resolution CT (HRCT) scan in the cases with lung tuberculoma. Methods Forty cases with lung tuberculoma and with materials of SCT scan and HRCT scan were analysed, according to the contour, edge, density and neighbourhood of lung tuberculoma. The visualising effects of lung tuberculoma characteristics were compared between SCT scan and HRCT scan. Results Calcification inside tuberculoma was respectively observed in 27.5% of SCT and 60% of HRCT.Following the bronchiectasis sign surrounding tuberculoma in 2.5% and 42.5%.The edge spiculation signs in 10% and 27.5%; The edge smooth in 57.5% and 47.5%.The satelite lesions in 37.5% and 40.0%.The signs of pleural thicking and concavity in 37.5% and 40.0%. If calcification, satelite lesions and bronchiectasis sign surrounding tuberculoma are considered as the characteristical signs of tuberculoma, there respectively are the correct diagnostic rate of 45.0% of SCT and 95.0% of HRCT. Conclusion HRCT holds higher ability to show the findings of tuberculoma than SCT.Therefore, it is necessary to keep HRCT as a routine scan after SCT for the diagnosis of tuberculoma.