摘要
目的探讨灶周肺气肿与灶周支气管扩张两种征象对肺结核增殖结节的CT诊断价值。方法回顾分析50例(3cm以下)肺结核增殖结节与20例(2.7cm以下)肺其他良性结节,在常规扫描发现结节后行病灶区薄层靶扫描及后处理MPR重建,并将以上病例分为两组(肺结核增殖结节为一组,肺其他良性结节为另一组),分别测量各自病例结节周围肺组织CT值,对比周边正常肺组织CT值;邻近支气管管径,对比伴行肺动脉管径;将以上结果进行精确数据分析。结果经过测量对比两组各自病例的结节周围肺组织CT值和周边正常肺组织CT值,测量邻近支气管管径和伴行肺动脉管径,发现灶周肺气肿在肺结核增殖结节中出现的病例39例,而在肺其他良性结节中出现仅为4例;灶周支气管扩张在肺结核增殖结节中出现35例,而在肺其他良性结节中出现仅为2例。经过统计学数据分析,两组差异有统计学意义(P<0.05)。结论CT上发现肺结节,行病灶区薄层靶扫描并MPR重建,测量对比结节周围CT值和周边正常肺组织CT值,测量对比病灶邻近支气管管径和相邻伴行肺动脉管径。如果病灶周围肺CT值<周边正常肺组织CT值(灶周肺气肿)或病灶邻近支气管管径>伴行肺动脉管径(灶周支气管扩张)这两个征象,则对肺结核增殖结节的诊断较有信心,且诊断准确率明显提高。
Objective To investigate the CT diagnostic value of perifocal emphysema and perifocal bronchiectasis in pulmonary tuberculosis proliferative nodules.Methods A retrospective analysis of 50 cases(less than 3 cm)of pulmonary tuberculosis proliferative nodules and 20 cases(less than 2.7 cm)of other benign pulmonary nodules was carried out.TLC and MPR reconstruction were performed after routine scanning.The above cases were divided into two groups(pulmonary tuberculosis proliferative nodules as one group and other benign pulmonary nodules as another group).CT values of lung tissues around nodules were measured and compared with those of normal lung tissues.The diameter of adjacent bronchial ducts was compared with that of accompanying pulmonary arteries.The above results were analyzed accurately.Results After measuring and comparing the CT values of peripheral pulmonary tissues and normal pulmonary tissues,the diameter of adjacent bronchial tube and accompanying pulmonary artery were measured.39 cases of perinodal emphysema were found in pulmonary tuberculosis proliferative nodules,and only 4 cases in other benign pulmonary nodules.There were 35 cases of pulmonary tuberculosis proliferative nodules and 2 cases of other benign nodules.After statistical analysis,the difference between the two groups was statistically significant(P<0.05).Conclusion The pulmonary nodules were found on CT,and the lesions were scanned with thin-layer target and reconstructed by MPR.The CT values around the nodules and surrounding normal lung tissues were measured and compared.The diameter of adjacent bronchial tube and the diameter of adjacent pulmonary artery were measured and compared.If the peripheral lung CT value<peripheral normal lung tissue CT value(perifocal emphysema)or the perifocal bronchial diameter>accompanied by pulmonary artery diameter(perifocal bronchiectasis),the diagnosis of pulmonary tuberculosis proliferative nodules is more confident,and the diagnostic accuracy is significantly improved.
作者
余跃丰
傅国良
张青春
YU Yue feng;FU Guoliang;ZHANG Qingchun(Department of Radiology,Guangfu Hospital of Zhejiang Jinhua,Jinhua 321000,P.R.China)
出处
《医学影像学杂志》
2019年第11期1880-1883,共4页
Journal of Medical Imaging