肺结核空洞与周围型肺癌伴囊腔形成的CT表现对照研究

Comparison study of CT features between cavitary tuberculosis and peripheral lung cancer with cavity formation

目的 回顾性分析肺结核空洞与周围型肺癌伴囊腔形成的CT表现特点,旨在提高对该两种病变的认识和CT诊断水平.方法 收集2011年8月至2014年10月大连市多家医院经胸部CT检查、手术病理和临床证实的22例肺结核空洞和24例周围型肺癌伴囊腔形成的临床与CT检查资料,除常规的临床资料外,着重对两组的CT征象进行比较和分析.两组资料比较采用独立样本￡检验,组间比较采用Pearson x2检验,以P＜0.05为差异有统计学意义.结果 肺结核组平均年龄（43.59±13.16）岁低于肺癌组[（62.92±10.21）岁]（t=5.591,P＜0.001）;两组发生部位上均以右肺多于左肺（以＂右肺例数/左肺例数＂表示,分别为＂14/8＂、＂15/9＂）,差异无统计学意义（x2=0.006,P=0.936）.肺癌组的囊腔形态不规则[41.7％ （10/24）]、内壁欠规整[62.5％（15/24）]、内壁结节[45.8％（11/24）]、腔内血管影[41.7％ （10/24）]和出现分叶征[20.8％ （5/24）]的比率均大于肺结核组[分别为：13.6％（3/22）、27.3％（6/22）、18.2％（4/22）、0％（0/22）和0％（0/22）],两组比较差异均有统计学意义（x2值分别为4.448、5.741、6.379、1.713、5.124,P值均＜0.05）;结核组出现＂卫星灶＂的比率[68.2％ （15/22）]大于肺癌组[0.0％（0/24）],差异有显著统计学意义（x2=24.282,P＜0.001）.结论 肺结核空洞与周围型肺癌囊腔形成的CT征象有较多不同,尤其是囊腔的形态与腔内结构及＂卫星灶＂有助于两者的鉴别诊断.

Objective Retrospective analysis the CT features of cavitary tuberculosis and peripheral lung cancer with cavity formation, to improve the understanding and CT diagnosis of these two diseases. Methods Twenty-two cases of pathology-proved cavitary tuberculosis and 24 cases of pathology-proved peripheral lung cancer with cavity formation were collected from August 2011 to October 2014 by some hospitals in Dalian, all the clinical information and chest CT examination were collected. To analysis the CT features differences between the two groups, in dependent sample t test and Pearson X2 test were used, P〈0.05 was considered statistically significant, Results The mean age of cavitary tuberculosis （43.59±13.16 years） was lower than lung cancer group （62.92± 10. 21 years） （t=5. 591, P〈0. 001） ; The right lung was more vulnerable to occur these two diseases than the left lung （number of cases in right lungs/number in left lungs was ＂14/8＂ and ＂15/9＂ respectively）, but not statistically significant （Z2 =0. 006, P=0. 936）. The emergence ratios of irregular cavity [41.7% （10/24）], unsmoothed inner wall [62.5%（15/24）], inner wall nodules [45.8% （11/24）], vascular within the lesion [41.7% （10/24）] and lobulated sign [20.8% （5/24）] in the lung cancer group were greater than cavitary tuberculosis group [13.6% （3/22）, 27. 3% （6/22）, 18. 2% （4/22）, 0. 0% （0/22） and 0.0% （0/22） respectively] （X2 values were 4. 448, 5. 741, 6. 379, 1. 713, 5. 124, P〈0. 05） ; but the ＂satellite lesions＂ sign proportion of cavitary tuberculosis group is greater than the lung cancer group [they were 68. 2% （15/22） and 0% （2/24） respectively] （Z2 =24. 282, P〈0. 001）. Conclusion CT features were different between cavitary tuberculosis and peripheral lung cancer with cavity formation, the cavity appearances and ＂satellite lesions＂ sign contribute to the differential diagnosis of the two diseases.