肺真菌病所致影像学肿块样改变与周围型肺癌鉴别的探讨

Study on the identification of peripheral lung cancer and the tumor sample changes of pulmonary fungal pneumonia

目的探讨肺真菌病所致影像学肿块样改变与周围型肺癌鉴别。方法通过13例肺真菌病影像学肿块样改变与手术病理证实15例周围型肺癌CT表现对比分析。结果 13例肺真菌感染中曲霉菌8例,隐球菌2例,白色念球菌2例,胞浆菌1例。13例肺真菌病影像诊断首诊均误诊;肺真菌病CT扫描有晕征改变、空洞、液化坏死、支气管空气征、凹陷征、深分叶征与周围性肺癌差异有统计学意义(P<0.05);"晕征"对诊断肺真菌病有意义。结论肺真菌病所致肿块周围见磨玻璃样影及"晕征"改变对鉴别诊断有帮助。

Objective To investigate the dif erential changes of imaging mass and peripheral lung cancer .Methods The CT findings of 15 cases of peripheral lung cancer and 13 cases of pulmonary fungal disease were compared.Results Among 13 cases of pulmonary fungal infec-tion,8 cases of Aspergil us,2 cases of latent infection,2 cases of Candida albicans,1 case of cytoplasmic bacteria.13 cases of pulmonary mycosis imaging diagnosis were misdiagnosed for the first time;fungal disease of the lung CT scan with halo sign change,empty,necrosis and liquefaction of air bronchogram sign,indentation,deep lobulation and there were significant dif erences in peripheral lung cancer;“halo sign”for the diagnosis of pulmonary fungal disease meaningful.Conclusion The changes of the glass like shadow and the “halo sign”of the lung caused by the pulmo-nary fungal disease are helpful to the dif erential diagnosis.