多样化CT征象鉴别周围性肺癌与肺结核

Value of various CT findings in the differential diagnosis of peripheral lung cancer and tuberculosis

目的探讨周围型肺癌与肺结核的有价值CT征象。方法回顾性分析经病理证实的58例肺癌及32例肺结核患者的多样化CT征象,肺癌为病例组,肺结核为对照组,提取有价值征象进行比较并归纳总结。结果肺癌组有腺癌46例、鳞癌8例、小细胞癌4例,主要征象分别是:分叶49(84.5%)例,毛刺39(67.2%)例,胸膜凹陷20(34.4%)例,晕征13(22.4%)例;肺结核组主要征象分别是:胸膜反应26(81.25%)例,卫星灶22(68.75%)例,钙化22(68.75%)例,毛刺26(81.25%)例。肺癌与肺结核组CT征象比较中,分叶、晕征、胸膜凹陷、钙化、卫星灶、胸膜反应等征象的分布差异均有统计学意义(P<0.05),而两者CT征象诊断准确度的比较中,肺癌分叶的诊断指数>150%,肺结核钙化、卫星灶、胸膜反应的诊断指数均>150%。结论周围型肺癌与肺结核的鉴别诊断中,分叶、胸膜凹陷、晕征、钙化、卫星灶、胸膜反应等CT征象对于肺癌与肺结核的诊断有一定临床价值。

Objective To explore the value of various CT findings of peripheral lung cancer and tuberculosis.Methods Diverse CT findings of 58 cases of lung cancer and 32 cases of pulmonary tuberculosis which was confirmed by pathology were retrospective analyzed. Patient with lung cancer was case group, and patient with tuberculosis was control group. Valuable signs were extracted and compared between 2 groups.Results Lung cancer group had 46 cases of adenocarcinoma, 8 cases of squamous cell carcinoma and 4 cases of small cell carcinoma.The main signs were： 49 cases（84.5%）with lobulate, 39（67.2%） with burr, 20 cases（34.4%） with pleural indentation, 13（22.4%） with halo sign .In main signs of tuberculosis, pleural reaction was 26 （81.25%）, the satellite focal point 22 （68.75%）, calcification 22 （68.75%）, burr 26 （81.25%）.Difference of lobulate, halo, pleural depression, calcification, satellite focal point and pleural reaction between lung cancer group and tuberculosis group were significant （P〈0.05）. The diagnostic index of lobule of lung cancer was 〉150%, the diagnostic indexes of tuberculosis calcification、 satellite focal area and pleural membrane reaction were all 〉 150%, which had a diagnostic value.Conclusion In the differential diagnosis of patients with peripheral lung cancer and tuberculosis, the CT signs such as lobulate, pleural depression, halo, calcification, satellite focal point and pleural reaction have a certain clinical value for the diagnosis of ung cancer and tuberculosis.