螺旋CT在鉴别肺癌及炎性假瘤中的诊断价值

The value of spiral CT used in the differential diagnosis of lung cancer and inflammatory pseudotumor

目的:探讨64排螺旋CT在鉴别炎性假瘤及肺癌中的诊断价值。方法:回顾性分析21例经手术和病理证实的炎性假瘤及53例经手术和病理证实的肺癌术前CT平扫及增强影像资料。结果:炎性假瘤及肺癌在CT表现上有许多重叠征象,均可出现分叶征、桃尖征、刀切征(平直征)、棘状突起、毛刺征、邻近胸膜增厚、空洞征、血管集束征和空洞征;在21例炎性假瘤患者中,分叶征出现2例,桃尖征出现4例,刀切征出现13例,有3例出现毛刺,4例出现空洞;而53例肺癌中,分叶征出现46例,毛刺征出现48例,血管集束征43例,有17例发现空洞,37例病变邻近胸膜出现胸膜凹陷征。在21例炎性假瘤患者中未发现淋巴结肿大;而在53例肺癌患者中有43例出现淋巴结转移。术前CT增强影像学改变发现,炎性假瘤大部分早期可见强化,延迟后强化明显,而肺癌强化呈快进快出样改变。结论:炎性假瘤及肺癌在CT表现上有重叠征象,故鉴别困难大,但结合患者病史、CT平扫及增强检查,在一定程度上可以进行鉴别。

Objective： To explore diagnosis value of CT in differentiating inflammatory pseudotumor and lung cancer. Methods： We made a retrospective analysis CT plain and enhanced imaging characteristics of 21 patients with surgically and pathologically proved inflammatory pseudotumor, and preoperative 53 cases confirmed by surgery and pathology of lung cancer. Results： Inflammatory pseudotumor and lung cancer on CT findings and there are many overlapping signs can appear lobulation, peach tip sign, knife sign（flat levy）, spines, and symptoms such as burr. Conclusion： There are many signs of overlap about the inflammatory pseudotumor and lung cancer on CT findings, so identification is very difficult, but the combination of history, plain and enhanced CT examination, to a certain extent, can be identified.