肺结核合并肺癌的CT表现与鉴别诊断探究

CT Findings and Differential Diagnosis of Pulmonary Tuberculosis Complicated with Lung Cancer

目的:研究肺结核合并肺癌的鉴别诊断中CT检查法的应用价值。方法:随机选取2015年1月-2018年12月本院接诊的肺结核合并肺癌病患50例为实验组,同时将本院同期接诊的单纯肺结核病患50例作为对照。两组都接受64排螺旋CT检查,综合分析两组的检查结果,并对其作出比较。结果:实验组刺激性胸痛、咳嗽、血性胸腔积液和声音嘶哑比例比对照组高,P<0.05。实验组中心型肺癌22例、周围型肺癌28例,螺旋CT检查提示肺部有不规则的肿块影,并伴有棘刺征、分叶征和毛刺征,胸膜空泡征和凹陷征不典型,空洞影、斑片渗出影和小结节影均不常见。结论:肺结核合并肺癌的CT表现以肺癌占位性特征为主,本病的发病率并不低,经动态分析患者的肺部CT表现,可为疾病的早期诊断提供重要指导。

Objective:To study the application value of CT examination in the differential diagnosis of pulmonary tuberculosis complicated with lung cancer.Methods:Fifty patients with pulmonary tuberculosis complicated with lung cancer who were admitted to the Hospital from January 2015 to February 2018 were randomly selected as the experimental group. Another 50 patients with pulmonary tuberculosis only who were admitted to the Hospital during the same period were taken as the control group. Both groups underwent 64-slice spiral CT examination, and the results of the two groups were analyzed comprehensively and compared.Results:The proportion of patients suffering from irritative chest pain, cough, bloody pleural effusion and hoarseness in the experimental group was higher than that in the control group, P<0.05. In the experimental group, there were 22 cases of central lung cancer and 28 cases of peripheral lung cancer. Spiral CT examination showed irregular lung mass shadow, accompanied by spine sign, lobulation sign and burr sign. The pleural vacuole sign and sag sign were not typical. Cavity shadows, patch oozing and nodular shadows were not common.Conclusion:The CT findings of pulmonary tuberculosis complicated with lung cancer are mainly characterized by space-occupying lung cancer, the incidence of which is not low. The dynamic CT analysis of the patients’ lungs can provide important guidance for the early diagnosis.