肺炎性假瘤与周围型肺癌的CT征象鉴别诊断

CT features and differentiation of pulmonary inflammatory pseudotumor and peripheral lung cancer

目的研究肺炎性假瘤与周围型肺癌的CT征象特征,探讨二者的影像鉴别诊断。方法回顾分析30例经手术和病理证实的肺炎性假瘤的CT征象,并与30例经手术和病理证实的周围型肺癌CT征象对照。结果肺炎性假瘤多呈圆形,主要表现有平直征(86.7%)、含气支气管征(50.0%)和空泡征(40.0%),无纵隔淋巴转移;周围型肺癌多呈结节状,主要表现分叶征(90.0%)、毛刺征(83.3%)、血管集束征(76.7%)和胸膜凹陷征(80.0%),常见纵隔淋巴转移。肺炎性假瘤与周围型肺癌发生部位、大小、空泡征、含气支气管征对鉴别诊断意义不大。结论肺炎性假瘤与周围型肺癌CT征象的不同有助于二者的鉴别诊断。

Objective To study the CT features of peripheral lung caneer（PLC） and pulmonary inflammatory pseudotumor（IPT） to provide the image data for the differentiation of PLC and IPT. Methods CT data of 30 patients with pulmonary inflammatory pseudotumor and 30 patients with peripheral lung cancer was analyzed retrospectively. Results Most of pulmonary inflammatory pseudotumors were round in shape with straight edge sign（86.7%）, air bronchogram sign（50.0%） and vacuole sign（40.0%）, with no mediastinal lymph node metastasis. Most of peripheral lung cancers were nodular in shape with lobulation sign（90.0%）, spiculation（83.3%）and vascular convergence（76.7%）, pleural indentation sign（80.0%） and mediastinal lymph node metastasis. The location, size, vacuole sign and air bronchogram were meaningless for differentiation of PLC and IPT. Conclusion The different CT signs of pulmonary inflammatory pseudotumor and peripheral lung cancer were helpful for the diagnosis and differentiation of these two diseases.