肺癌空洞的CT诊断与鉴别诊断

CT Diagnosis and Differential Diagnosis of the Lung Cancer Cavity

目的提高肺癌空洞形成的CT诊断与鉴别诊断水平。方法搜集经临床、实验室及手术确诊的37例肺癌空洞及的资料完整,及其它良性空洞与空腔性病变34例的CT图像进行回顾性分析。结果肺癌空洞主要CT表现有:厚壁偏心性空洞,可有壁结节,内壁凹凸不平可有分叶征、毛刺征、胸膜凹陷征等恶性肿瘤征象增强扫描空洞壁中等至明显强化;结核性空洞壁薄、厚度较均匀,内壁光滑周围有卫星灶,多位于上叶尖后段及下叶背段,增强扫描空洞壁,可有轻至中等强化。肺脓肿脓腔:多为厚壁空洞,内壁光滑,内可出现液平面,周围有渗出性炎性灶,临床症状典型。肺霉菌病空洞可为薄壁亦可为厚壁,多发常见,内壁亦可凹凸不平,部分可见空气新月征,其它良性病变空洞形成有各自特点,与肺癌空洞有相应鉴别诊断要点。结论认识并掌握肺部良恶性空洞常见CT表现,认真分析病灶形态、密度、边缘与大小并测量空洞区域的CT值变化,空洞壁的强化程度并结合临床表现及其它检查,综合分析判断,有助于减少误诊。

Objective To improve the void formation of CT diagnosis and differential diagnosis of lung cancer cavity.Methods The CT imaging data of 37 cases of lung cancer cavity which approved by Operation and pathology was collected, and compared with the 34 cases of benign hollow and empty lesions.Results The main performance of CT of lung cancer cavity include： thick wall and eccentric hole ,sign of lobulation,sign of spicule,pleural indentation sign, enhancement scanning reinforced hollow walls moderately to clear; Tuberculous cavity could manifested as thin wall, uniform thickness, smooth inner wall around with satellite foci, in after the blade tip period and lower lobe dorsal segment, enhanced scan and empty wall can have light to moderate strengthening. Pulmonary abscess： thick and smooth wall,fluid level, with exudative inflammatory lesion around then cavity, and typical clinical symptoms. Lung mycosis cavity could be manifested as thick or thin wall, comose, coarse inwall, part of the visible air crescent sign. Other benign lesions cavity formed their own characteristics, empty have a corresponding key points of differential diagnosis. With lung cancer.Conclusion Understanding and mastering the common CT manifestations benign and malignant lung empty , carefully analysis lesion form, density, edge , size and CT value of measuring hole area change, hollow wall reinforcement degree in combination with clinical manifestations and other inspections, comprehensive analysis and judgment helps to reduce the misdiagnosis.